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Advisor(s)
Abstract(s)
As ectopias de córtex suprarrenal são uma patologia rara, particularmente no sexo
feminino. É frequente a sua presença em idade pediátrica, no entanto a maioria destes
nódulos sofrem um processo de involução até à idade adulta. Formam-se durante o
desenvolvimento embrionário, quando as glândulas suprarrenais primordiais estão
adjacentes às gónadas e rins, motivo pelo qual, os tecidos ectópicos de córtex suprarrenal
se encontram predominantemente na periferia destes órgãos. Esta patologia é na maioria
das vezes um achado acidental no decorrer de cirurgias abdomino-pélvicas.
Neste trabalho de tese, descreve-se o caso clínico de uma mulher de 58 anos na qual se
identificaram acidentalmente dois nódulos milimétricos de tecido cortical suprarrenal na
periferia de ambas as trompas de Falópio. Identificaram-se no decorrer de uma cirurgia
pélvica realizada por motivo de um teratoma maduro do ovário e de um fibroma no ovário
contralateral. A paciente não apresentava qualquer sintomatologia derivada destes nódulos
suprarrenais. Foi feito seguimento em consulta de endocrinologia não tendo ocorrido
complicações associadas a alterações hormonais suprarrenais.
A revisão da literatura, evidencia que a apresentação deste caso é típica desta patologia.
Conclui-se que por ser uma patologia rara e de difícil identificação, com diversas variantes
de apresentação, devem ser desenvolvidas metodologias de diagnóstico, tratamento e
acompanhamento estandardizadas.
Adrenal cortex ectopias are a rare pathology, particularly in females. Their presence is frequent in pediatric age, however, they often undergo involution. They are formed during embryonic development when the primordial adrenal glands are adjacent to the gonads and kidneys. Consequently, remnants of adrenal tissue are predominantly found in the periphery of these organs. This pathology is mostly an incidental finding during abdominalpelvic surgeries. In this thesis work, a clinical case is described involving a 58 year old woman in whom two millimeter-sized nodules of adrenal cortical tissue were accidentally found in the periphery of both Fallopian tubes. They were identified during a pelvic surgery performed due to a mature ovarian teratoma and a fibroma in the contralateral ovary. The patient did not exhibit any symptoms related to these adrenal nodules. Follow-up in an endocrinology consult revealed no hormonal complications. The literature review conducted shows that the presentation of this clinical case is typical of this pathology. We can conclude that due to its rarity and challenging identification with different presentation variants, a standardized methodology for diagnosis, treatment, and follow-up should be developed.
Adrenal cortex ectopias are a rare pathology, particularly in females. Their presence is frequent in pediatric age, however, they often undergo involution. They are formed during embryonic development when the primordial adrenal glands are adjacent to the gonads and kidneys. Consequently, remnants of adrenal tissue are predominantly found in the periphery of these organs. This pathology is mostly an incidental finding during abdominalpelvic surgeries. In this thesis work, a clinical case is described involving a 58 year old woman in whom two millimeter-sized nodules of adrenal cortical tissue were accidentally found in the periphery of both Fallopian tubes. They were identified during a pelvic surgery performed due to a mature ovarian teratoma and a fibroma in the contralateral ovary. The patient did not exhibit any symptoms related to these adrenal nodules. Follow-up in an endocrinology consult revealed no hormonal complications. The literature review conducted shows that the presentation of this clinical case is typical of this pathology. We can conclude that due to its rarity and challenging identification with different presentation variants, a standardized methodology for diagnosis, treatment, and follow-up should be developed.
Description
Keywords
Ectopia Suprarrenal Embriologia Suprarrenal Resquícios Suprarrenais Suprarrenal Anómala Trompas de Falópio