Ectopic adrenal tissue: an incidental finding during inguinoscrotal operations in children

Oğuzkurt, Pelin; Öz, Sedat; Kayaselçuk, Fazi̇let

doi:10.1007/s10029-002-0056-2

Cited by 19 publications

(23 citation statements)

References 4 publications

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“…In the pediatric population, ectopic adrenal tissue found during inguinoscrotal procedures has been extensively documented 1,5 with a right-sided preponderance. There is an increased incidence of ectopic adrenal tissue within the spermatic cord of males with undescended testes, 5 ranging from 1.6% to 5.1%.…”

Section: Discussionmentioning

confidence: 99%

“…8 Macroscopically, the appearance of ectopic adrenal tissue is characteristic (a round, yellow nodule, firm in consistency, embedded in the cremasteric fibres, resembling a fat lobule). 1 Adrenal rests situated far from the original gland are composed entirely of cortical adrenal tissue with no evidence of medullary cells, but the more proximal cells may contain medulla. Usually a capsule of connective tissue with small blood vessels can be seen surrounding these nodules.…”

Section: Discussionmentioning

confidence: 99%

“…The reticularis layer is usually only seen in older children. 1 This can be explained when the embryological route and descent pathway are considered.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…1 In 1740, Morgagni first described ectopic adrenal tissue in the vicinity of the adrenal gland, 2 and in 1885 Dagonest noted the presence of adrenocortical tissue in the spermatic cord of an infant. 3 Other non-adrenal sites include the coeliac axis, renal parenchyma, broad ligament and ovary; the placenta, hepatic, pulmonary and intracranial lesions, including eleventh cranial deposits, have also been described.…”

Section: Introductionmentioning

confidence: 99%

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Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male

Floyd

Itam

Nasir

et al. 2014

CUAJ

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Aberrant adrenal tissue near the adrenal gland is common, but the finding of ectopic adrenal tissue in structures around the spermatic cord and testis is rare. We describe a case of concomitant seminoma and ectopic adrenal tissue of the spermatic cord occurring in an adult patient who had undergone orchidopexy as a child. IntroductionAberrant adrenal tissue near the adrenal gland is common, but the finding of ectopic adrenal tissue in structures around the spermatic cord and testis remains rare. 1 In 1740, Morgagni first described ectopic adrenal tissue in the vicinity of the adrenal gland, 2 and in 1885 Dagonest noted the presence of adrenocortical tissue in the spermatic cord of an infant.3 Other non-adrenal sites include the coeliac axis, renal parenchyma, broad ligament and ovary; the placenta, hepatic, pulmonary and intracranial lesions, including eleventh cranial deposits, have also been described. 4,5 Case reportA 45-year-old male was referred to the outpatient department with a 3-month history of a painless right testicular mass. There was no history of trauma, recent infection, systemic upset or weight loss. His history was remarkable for essential hypertension and an inguinal orchidopexy at age 13 for an undescended right testicle. He had fathered 6 children.Physical examination revealed a soft non-tender abdomen with a right inguinal scar. There was a discreet mass in the upper pole of his right testicle, a right scrotal scar consistent with his orchidopexy and a normal left hemiscrotum. Tumour markers (alpha fetoprotein, beta human chorionic gonadotrophin and lactate dehydrogenase) were normal. Scrotal ultrasound demonstrated a 9-mm mass in the upper pole of the right testicle and a nodule in the right spermatic cord (Fig. 1). He underwent a right radical orchidectomy via his old inguinal scar. Final histopathological analysis revealed a classic seminoma, which stained positive for placental alkaline phosphatase (PLAP), but negative for Ber-H21, inhibin and Alphafeto protein (Fig. 2). No lymphovascular invasion was noted and it was staged as a pT1 lesion. The nodule in the spermatic cord contained morphological features consistent with an adrenal rest (Fig. 3). DiscussionIn the pediatric population, ectopic adrenal tissue found during inguinoscrotal procedures has been extensively documented 1,5 with a right-sided preponderance. There is an increased incidence of ectopic adrenal tissue within the spermatic cord of males with undescended testes, 5 ranging from 1.6% to 5.1%. 3,6 Autopsy series have shown an incidence of ectopic adrenal tissue adjacent to the native adrenal of up to 32% in adults.7 However, the incidence of ectopic adrenal tissue in the spermatic cord of adults is significantly lower at 1%. 8 Macroscopically, the appearance of ectopic adrenal tissue is characteristic (a round, yellow nodule, firm in consistency, embedded in the cremasteric fibres, resembling a fat lobule).1 Adrenal rests situated far from the original gland are composed entirely of cortical adrenal tissue with n...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The reticularis layer is usually only seen in older children. 1 This can be explained when the embryological route and descent pathway are considered.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male

Floyd

Itam

Nasir

et al. 2014

CUAJ

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Adrenal Gland

Özgüner¹

2016

Bergman's Comprehensive Encyclopedia of Human Anatomic Variation

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Presence of ectopic adrenocortical tissues in inguinoscrotal region suggests an association with undescended testis

2006

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Ectopic adrenocortical tissues (EAT) are rare pathologies in children. They are frequently encountered in the inguinal region incidentally during surgical procedures but they are also classically known to be located from diaphragm to pelvis. EAT were investigated during inguinal procedures including inguinal hernia, hydrocele, hydrocele of cord and undescended testis (UDT) in 1,069 patients, 159 girls, 910 boys, from April 1997 until April 2006. All these nodules were confirmed to be adrenocortical tissues after histopathological examinations. Statistical analysis was done with Fisher's exact test. EAT were noted on the plexus pampiniformis external to processus vaginalis of 22 male patients (1.73%) during inguinal explorations. This figure was 1.63% for inguinal explorations of inguinal hernia, hydrocele and hydrocele of cord and 5.1% for UDT. This difference was statistically significant (P<0.0001). There were no EAT detected during inguinal exploration of female patients. EAT are uncommon pathologies seen during inguinoscrotal explorations. Incidence of EAT is significantly increased with UDT. This increase may be explained with the embryological events that take place during adrenal and gonadal development. The relatively low observation of EAT in girls may be due to the localization of gonads and association of EAT with gonadal position. Adrenal rests in inguinal region may suggest an association with descent of gonads.

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Ectopic adrenal tissue: an incidental finding during inguinoscrotal operations in children

Cited by 19 publications

References 4 publications

Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male

Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male

Adrenal Gland

Presence of ectopic adrenocortical tissues in inguinoscrotal region suggests an association with undescended testis

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