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Ectopic adrenocortical tissue along the inguinoscrotal path of children
George Vaos1, Nick Zavras, Irene Boukouvalea
1Departament of Paediatric Surgery, Penteli General Children's Hospital, Athens, Greece. gvaos@hotmail.com
This study assessed the occurrence of ectopic adrenocortical tissue in the inguinal region of children and proposed an appropriate scheme of treatment. Three hundred sixteen inguinoscrotal operations were performed on 289 consecutive patients over a period of 12 months. Nodules considered as ectopic adrenocortical tissue were excised from eight patients (2.5%), and microscopic examination was performed using hematoxylin-eosin staining. Ectopic adrenocortical nodules were found in six male patients (1.9%). The nodules were located along the spermatic cord, in the apex of the hernial sac, and between the testis and epididymis. Microscopically, they were consisted of adrenal cortex surrounded by fibrous tissue. Hyperplasia or neoplastic changes were not identified. Surgeons should be aware that nodules along the inguinoscrotal path may represent ectopic adrenocortical remnants. These nodules should be recognized and removed whenever they are encountered incidentally as they may be associated with hyperplasia or neoplastic changes. Routine search for them is not necessary.
This study assessed the occurrence of ectopic adrenocortical tissue in the inguinal region of children and proposed an appropriate scheme of treatment. Three hundred sixteen inguinoscrotal operations were performed on 289 consecutive patients over a period of 12 months. Nodules considered as ectopic adrenocortical tissue were excised from eight patients (2.5%), and microscopic examination was performed using hematoxylin-eosin staining. Ectopic adrenocortical nodules were found in six male patients (1.9%). The nodules were located along the spermatic cord, in the apex of the hernial sac, and between the testis and epididymis. Microscopically, they were consisted of adrenal cortex surrounded by fibrous tissue. Hyperplasia or neoplastic changes were not identified. Surgeons should be aware that nodules along the inguinoscrotal path may represent ectopic adrenocortical remnants. These nodules should be recognized and removed whenever they are encountered incidentally as they may be associated with hyperplasia or neoplastic changes. Routine search for them is not necessary.
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