Question: I am scheduled to have a bilateral adrenalectomy and have been warned that sometimes there is adrenal tissue in the body other than just in the adrenal glands. Is this true?

Answer: This is called adrenal rest cells. They are located sometimes in the liver, sometimes in the testes or ovaries. In rare circumstances they may be reactivated in the context where adrenals are removed and the patient is under replaced for years, that is, ACTH levels remain chronically elevated. In this context, adrenal rest cells may become reactivated and secrete Cortisol. This is a rare situation and very seldom happens to anyone who is on steroid replacement therapy at normal doses and pays attention to their dosing regimen.