title: Ovarian serous cystadenoma with ectopic adrenal tissue in a 65-year-old patient: A case report.
abstract: BACKGROUND
  Ectopic adrenal tissue is a very rare entity in adult females, especially in the ovary, and is generally diagnosed incidentally during surgery. Although it can present at various sites during childhood, it becomes atrophic by adulthood due to normally functioning adrenal glands. Patients are predominantly asymptomatic; however, in some cases endocrine symptoms such as hypertension and fasciotruncal obesity due to hormonal activity can be seen or neoplastic transformation can appear.
  
  
  METHODS
  A 65-year-old patient with progressive pelvic pain and postmenopausal vaginal bleeding was evaluated by transvaginal ultrasound, which revealed bilateral adnexal masses measuring 5cm in size and a normal uterus with an increased endometrial thickness of 7mm. Initially the endometrial sampling result was reported as benign. The patient underwent abdominal hysterectomy and bilateral salpingo-oophorectomy and the pathological diagnosis was again benign, with serous ovarian cystadenoma being found in both ovaries. The pathologist also reported incidental ectopic adrenal tissue on the wall of the left ovarian cystadenoma.
  
  
  CONCLUSIONS
  Ectopic adrenal tissue is infrequent in female genital organs especially at older ages. Only a few cases of ovarian ectopic adrenal tissue have been reported. To the best of our knowledge the present case is the fourth report in the English literature, and is of additional importance given the patient's age.
  
  
  CONCLUSIONS
  Ectopic adrenal tissues are generally asymptomatic and revealed incidentally during surgery; however some cases have demonstrated the risk of neoplastic transformation. Therefore, surgeons must be aware of this rare entity that bears the risk of malignancy, and should surgically remove all suspicious lesions.
authors.affiliation: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Çağdaş
authors.initials: Ç
authors.lastname: Şahin
authors.affiliation: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey. Electronic address: enestaylanmd@gmail.com.
authors.forename: Enes
authors.initials: E
authors.lastname: Taylan
authors.affiliation: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Akdemir
authors.affiliation: Department of Pathology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Zekioglu
authors.affiliation: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Parvane
authors.initials: P
authors.lastname: Seyidova
authors.affiliation: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Ahmet Mete
authors.initials: AM
authors.lastname: Ergenoglu
keywords: Adrenal tissue; Case report; Ectopia; Ovarian cystadenoma