Evaluation of children with inguinoscrotal ectopic adrenal tissues

625 175


To evaluate 6 cases of inguinoscrotal ectopic adrenal nodules, which were detected in 2 hospitals. Materials and methods: A total of 296 male patients who had inguinoscrotal surgery between 2009 and 2011 were retrospectively evaluated. Bright yellow nodular lesions, resembling the adrenal tissue, were excised during surgery. Histopathologic examination of these samples was performed and the clinical data of the patients were evaluated. Results: Ectopic adrenal tissue was detected in 6 patients (2.02%). The mean age of the patients was 4.6 years (range: 3 months to 9 years) years. Ectopic adrenal nodules were localized in the spermatic cord, in the vicinity of the epididymis and appendix testis, on the epididymis, and on the tunica albuginea of an atrophic testis undergoing orchiectomy due to intraabdominal localization. Adrenal cortex cells were found in 5 patients, and both cortex and medullar cells were found in 1 patient. No malign transformation was detected. Hormonal, biochemical, hematologic, and urinary analyses did not yield any significant results. Conclusion: Inguinoscrotal ectopic adrenal tissues are incidentally detected lesions during surgical interventions. They are benign lesions associated with no significant symptoms. Nevertheless, it is considered to be of benefit to remove these tissues in order to perform histopathological evaluation for differential diagnosis.


Key words: Ectopic adrenal tissue, inguinoscrotal surgery, ectopic adrenal medulla

Full Text:



Schechter DC. Aberrant adrenal tissue. Ann Surg 1968; 167: 421–

Wolloch Y, Ziv Y, Dintsman M. Accessory adrenal: an incidental finding during orchiopexy. Panminerva Med 1986; 28: 47–9.

Roggia A, Marandola P, Broggini P, Bono P, deFrancesco O, Rovati L. Ectopic adrenal cortex tissue in the spermatic cord: clinico-surgical implications. Arch Esp Urol 1991; 44: 1165–6.

Anderson JR, Ross AH. Ectopic adrenal tissue in adults. Postgrad Med J 1980; 56: 806–8.

Rosai J. Adrenal gland and other paraganglia. In: Rosai J, editor. Ackerman’s surgical pathology. 7th ed. St Louis (MO): C. V. Mosby. 1989; p.789–819.

Graham LS. Celiac accessory adrenal gland. Cancer 1953; 6: 149–52.

Vestfrid MA. Ectopic adrenal cortex in neonate liver. Histopathology 1980; 4: 669–72.

Nistal M, Paniagua R. Testicular and epididymal pathology. New York: Thieme-Stratton Inc.; 1984.

McLennan A. On the presence of adrenal rests in the walls of hernial sacs. Surg Gynec Obst 1919; 29: 387.

Mari M, Cagnazzi E, Bollito E, Bellina M. Ectopic adrenal cortex tissue in the spermatic cord in association with testicular cancer. Urol Int 2004; 73: 191–2.

Mendez R, Tellado MG, Somoza I, Liras J, Sanchez-Abuin A, Pais E et al. Ectopic adrenal tissue in the spermatic cord in pediatric patients: surgical implications. Int Braz J Urol 2006; 32: 202–7.

Sullivan JG, Gohel M, Kinder RB. Ectopic adrenocortical tissue found at groin exploration in children: incidence in relation to diagnosis, age and sex. BJU Int 2005; 95: 407–10.

Dobanovacki DS, Maric DM, Maric DL, Vuckovic N, Jokic RR, Slavkovic AR et al. Ectopic adrenocortical tissue: an incidental finding during inguinal surgery in children. Fetal Pediatr Pathol 2013; 31: 32–7

Ketata S, Ketata H, Sahnoun A, FakhFakh H, Bahloul A, Mhiri MN. Ectopic adrenal cortex tissue: an incidental finding during inguinoscrotal operations in pediatric patients. Urol Int 2008; 81: 316–9

Mares AJ, Shkolnik A, Sacks M, Feuchtwanger MM. Aberrant (ectopic) adrenocortical tissue along the spermatic cord. J Pediatr Surg 1980; 15: 289–92.

Wang XL, Dou JT, Gao JP, Zhong WW, Jin D, Hui L et al. Laparoscope resection of ectopic corticosteroid-secreting adrenal adenoma. 2012; 33: 265–7.

Vela Navarrete R, Barat A, Berrocal A, Lopez de Alda A, Quezada F. Testicular adrenal rests tumor: a difficult diagnosis. Actas Urol Esp 1990; 14: 146–8.

Abe T, Matsuda H, Shindo J, Nonomura K, Koyanagi T. Ectopic pheochromocytoma arising in the spermatic cord 5 years after removal of bilateral carotid body tumors and adrenal pheochromocytomas. Int J Urol 2000; 7: 110–1.

Borazan E, Karakök M, Baltacı Y, Bağcı C. The effects of experimentally induced intraabdominal hypertension on adrenal glands. Turk J Med Sci 2012; 42: 567–72.