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Steroidogenesis in Pediatric Adrenal Rests in the Spermatic Cord
Tsubasa Shironomae1, Yuto Yamazaki2, Shinako Takeda3
1Department of Urology, Miyagi Children's Hospital, Sendai, Japan; Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
The Journal of Surgical Research
|February 11, 2026
Summary
Pediatric adrenal rests in the spermatic cord exhibit normal steroidogenesis, with fetal adrenal cortex present in infancy and decreasing with age. Aldosterone biosynthesis may differ from eutopic adrenal glands.
Area of Science:
- Pediatric Endocrinology
- Surgical Pathology
- Steroidogenesis
Background:
- Adrenal rests are ectopic adrenal tissues found in the spermatic cord.
- Evaluating steroidogenesis in these rests is crucial for understanding pediatric adrenal function.
Purpose of the Study:
- To investigate steroidogenesis and androgen effects in pediatric adrenal rests within the spermatic cord.
Main Methods:
- Retrospective review of pediatric surgical explorations for spermatic cord masses.
- Immunohistochemical analysis of steroidogenic enzymes, androgen receptor, and Ki-67 in resected adrenal rests.
Main Results:
- Ten adrenal rests identified in nine pediatric patients.
- Adrenal rests showed multiple cortical zones, with fetal cortex present in infancy, decreasing with age.
- Immunoreactivity for key steroidogenic enzymes (CYP11B2, P450 17A1) and androgen receptor detected, varying with age and zone.
- Ki-67 proliferation markers were primarily in infancy.
Conclusions:
- Steroidogenesis in spermatic cord adrenal rests is considered normal, though aldosterone biosynthesis may differ from eutopic adrenal glands.
- Age-related changes in adrenal rests include the presence of fetal cortex and varying enzyme expression.
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