Tumor-like Lesions, Pathology of the Broad Ligament and Other Uterine Ligaments

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Adrenocortical remnants, appearing as microscopic nodules of adrenal cortical cells in the broad ligament, are an incidental finding that can rarely develop into a functional or nonfunctional adenoma.

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This encyclopedia entry describes adrenal rests, which are microscopic nodules of adrenal cortical cells found in the broad ligament or mesosalpinx. These lesions occur in approximately 23% of carefully sectioned specimens and typically present as incidental, benign findings that require no treatment. While they can rarely undergo hypertrophy or develop into functional adenomas, they are generally considered harmless accessory tissue. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Adrenal Rest Synonyms Adrenocortical remnants. Definition Small discrete microscopic nodules of adrenal cortical cells. Clinical Features - Incidence Adrenocortical rest have been identified in 23% of carefully sectioned broad ligaments and collections of Hilus cells are occasionally encountered (Falls 1955). - Site Broad ligament or mesosalpinx. Clinical Presentation They are most commonly an incidental finding (Adashi et al. 1980). - Treatment None. - Outcome Benign accessory tissue (Sasano et al. 1997). Macroscopy Grossly, they appear as small microscopic, yellow nodules, but they may be obscured by fat (Roth et al. 1996). Microscopy Histologically all three cortical layers are recognizable. These remnants may become hypertrophic secondary to adrenal destruction or may, rarely, give rise to a functional or nonfunctional cortical adenoma (Wild et al. 1988). Molecular Features Not clinically relevant. Endometriosis Definition The presence of ectopically located endometrial tissue involving... Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only References and Further Reading Adashi, E. Y., Rosenshein, N. B., Parmley, T. H., & Woodruff, J. D. (1980). Histogenesis of the broad ligament adrenal rest. International Journal of Gynaecology and Obstetrics, 18, 102–104. Falls, J. L. (1955). Accesory adrenal cortex in the broad ligament. Incidence and functional significance. Cancer, 8, 143–150. Goldberg, J. M., Falcone, T., & Diamond, M. P. (2019). Current controversies in tubal disease, endometriosis, and pelvic adhesion. Fertility and Sterility, 112, 417–425. Henderson, D. W., Shilkin, K. B., & Whitaker, D. (1998). Reactive mesothelial hyperplasia vs mesothelioma, including mesothelioma in situ: A brief review. American Journal of Clinical Pathology, 110(3), 397–404. Kobayashi, H., Kawahara, N., Ogawa, K., & Yoshimoto, C. A. (2020). Relationship between endometriosis and obstetric complications. Reproductive Sciences, 27, 771–778. Roth, L. M., Davis, M. M., & Sutton, G. P. (1996). Steroid cell tumor of the broad ligament arising in an accessory ovary. Archives of Pathology & Laboratory Medicine, 120, 405–409. Rowlands, I. J., Nagle, C. M., Spurdle, A. B., & Webb, P. M. (2011). Gynecological conditions and the risk of endometrial cancer. Gynecologic Oncology, 123, 537–541. Sasano, H., Sato, S., Yajima, A., Akama, J., & Nagura, H. (1997). Adrenal rest tumor of the broad ligament: Case report with immunohistochemical study of steroidogenic enzymes. Pathology International, 47, 493–496. Wild, R. A., Albert, R. D., Zaino, R. J., et al. (1988). Virilizing Para-ovarian tumors: A consequence of Nelson’s syndrome? Obstetrics and Gynecology, 71, 1053–1156. Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2023 Springer Nature Switzerland AG About this entry Cite this entry Alvarado-Cabrero, I. (2023). Tumor-like Lesions, Pathology of the Broad Ligament and Other Uterine Ligaments. In: Stolnicu, S., Ali-Fehmi, R. (eds) Gynecologic Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-97378-0_5649 Download citation DOI: https://doi.org/10.1007/978-3-030-97378-0_5649 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-97377-3 Online ISBN: 978-3-030-97378-0 eBook Packages: MedicineReference Module Medicine

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