Ectopic adrenal cortical rest in the fallopian tube - a rare incidental finding

Ectopic adrenal tissue (EAT) is a rare developmental anomaly most frequently observed along the genitourinary tract, usually in pediatric males. Its persistence into adulthood, particularly within the fallopian tube, is exceedingly uncommon. We present the case of a 43-year--old woman who underwent total laparoscopic hysterectomy and bilateral salpingectomy for symptomatic uterine leiomyomas. Histopathologic examination incidentally revealed a well-circumscribed nodule in the right fallopian tube composed of polygonal cells with clear cytoplasm, morphologically resembling adrenal cortical tissue. Immunohistochemical staining demonstrated strong positivity for inhibin and calretinin, confirming the diagnosis of an ectopic adrenal cortical rest. No clinical or biochemical evidence of hormonal hyperfunction was noted. This rare finding expands the limited body of literature on fallopian tube EAT, emphasizing the importance of recognizing this entity to avoid misdiagnosis with metastatic clear cell lesions.