Aberrant Adrenocortical Tissue Associated with Resected Lipoma of Spermatic Cord in an Adult

Abstract

Aberrant adrenocortical tissue in spermatic cord is rare in adult population. We report an unusual case of a 52-year-old male patient with an aberrant adrenocortical tissue which is incidentally resected within lipoma of spermatic cord and identified on microscopic examination. Although he was diagnosed with right inguinal hernia, there was no significant hernia orifice intraoperatively. When the 2nd operation by anterior open approach was undergone, there was a fat-like tissue adhered to the spermatic cord. It was removed and the histopathological finding first revealed aberrant adrenocortical tissue in the resected lipoma of spermatic cord (Figure 1). This abnormal tissue is usually found incidentally during inguinal operation. In general, most of the aberrant adrenal tissue becomes atrophic by adult life. Moreover, it is not clinically significant and also not associated with endocrine abnormalities.

Ectopic Adrenocortical Tissue Attached to the Inguinal Sac in an Adult

“…Embryologically the adrenal gland origins from two primordia. The fetal adrenal cortex is derived from the mesoderm and the medulla arises from the ectoderm [2][3][4]. It is generally accepted that adrenal remnants result from the displacement and separation of cortex during the migration and descent of the gonads during the embryonic period.…”

“…The pathological appearance of this ectopic tissue in the inguinal canal is characteristic. Findings show a yellowish round nodule of 1-5 mm in diameter within cremasteric fibers [3][4][5]7]. The question of whether we should remove these nodules is important.…”

“…Some authors state that aberrant adrenal tissues may be existing in 50% of newborns [2,3]. The incidence of adrenal tissue in the spermatic cord is less than 1% in adults [4,5]. The low rate is thought to be due to atrophy of ectopic tissue in advanced ages.…”

“…Austin J Surg 8(1): id1261 (2021) -Page -02 Submit your Manuscript | www.austinpublishinggroup.compheochromocytoma, Leydig cell tumors and adrenal adenomas can very rarely develop from these ectopic tissues[1][2][3][4][5][6].…”