Case ReportsEctopic Low-grade Adrenocortical Carcinoma in the Spinal Region: Immunohistochemical and Molecular Cytogenetic Study of a Pediatric CaseRodriguez, Fausto J. MD; Scheithauer, Bernd W. MD; Erickson, Lori A. MD; Jenkins, Robert B. MD, PhD; Giannini, Caterina MD, PhDAuthor Information Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN Supported in part by NIH training grant T32 NS07494-04 (F.J.R.). Correspondence: Fausto J. Rodriguez, MD, Mayo Clinic College of Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905 (e-mail: firstname.lastname@example.org). The American Journal of Surgical Pathology: January 2009 - Volume 33 - Issue 1 - p 142-148 doi: 10.1097/PAS.0b013e318180deda Buy SDC Metrics Abstract Ectopic adrenocortical neoplasms arising in the nervous system are very rare. We encountered an intradural, extramedullary case of an adrenocortical neoplasm of indeterminate malignant potential affecting a spinal nerve root in the distal lumbar region of a 5-month-old girl. The lesion recurred 6 months after the initial gross total resection. The tumor in both resections had increased mitotic activity (5/10 high power fields) and MIB-1 labeling indices of 23% and 33% at initial resection and recurrence, respectively. Both tumors demonstrated gains of chromosomes 5 and 12 by interphase cytogenetics, whereas insulin growth factor 2 was identified in the recurrent tumor by immunohistochemistry. This report demonstrates that ectopic adrenocortical tumors in the nervous system may exhibit clinicopathologic and cytogenetic features suggestive of adrenocortical carcinoma. © 2009 Lippincott Williams & Wilkins, Inc.