Adrenal fusion anomaly

Abstract

CASE REPORT A 35­year­old female, G2P1L1, underwent an antenatal scan at 36 weeks. Large thoraco­lumbar neural tube defect and Arnold­Chiari malformation type II were detected in the fetus. A female fetus weighing two kg was delivered following induction for termination of pregnancy. Autopsy confirmed Arnold­ Chiari malformation, and meningomyelocele at thoraco­ lumbar region. Histology showed features suggestive of amniotic fluid aspiration in non­aerated lungs. A transverse band of tissue across the midline was noted above the kidneys, posterior to aorta. No separate adrenals were identified in superior poles of kidney (Figure 1A, B). Histologic examination of transverse band of tissue showed a capsulated tissue with cells displayed in zonal pattern. A compact cellular layer formed outer layer, columns of paler cells in the middle and smaller cells in cords on inner side consistent with adrenal gland morphology (Figure 2). This confirmed the diagnosis of adrenal fusion anomaly. DISCUSSION Adrenal gland agenesis, hypoplasia and accessory gland are common congenital anomalies of adrenal CLINICAL IMAGES OPEN ACCESS