A 54-year-old man with a 5-year history of Parkinson's disease was treated with and autograft of adrenal medulla into the right caudate nucleus and died 4 months after surgery. Postmortem examination revealed that the graft was necrotic. It consisted mainly of reticulin and collagen fibrosis without catecholaminergic cell bodies identified either by immunohistochemistry or by in situ hybridization with labeled human tyrosine hydroxylase (TH) cDNA probe. Sparse TH-immunoreactive fibers, which did not stain for dopamine-beta-hydroxylase (DBH), ran through the graft. In contrast, intense staining for these catecholaminergic markers was found in the untransplanted adrenal medulla. Densely packed TH-positive, DHB-negative fibers were found in a restricted zone of the host striatum at the periphery of the graft. This effect was selective since the density of other neurons was not modified. The present study describes an additional patient in whom adrenal medulla autotransplantation failed to improve the parkinsonian disability. It suggests, however, that adrenal medulla grafts may stimulate the sprouting of striatal dopaminergic fibers in a limited zone of the grafted striatum.