Ectopic adrenocortical nodules along the spermatic cord of children.

OBJECTIVE

Nodules of ectopic adrenal cortex are found incidentally during inguinal operations. These rests have some clinical significance as they may undergo marked hyperplasia in conditions associated with excessive ACTH production, and occasionally may give rise to neoplasms. In the present study, it is aimed to evaluate the ectopic remnants of adrenal tissue encountered during the inguinal operations in children.

PATIENTS AND

METHODS

Four hundred and fifty-two inguinal operations were performed on 397 children (325 male/72 female; mean age 2.7 years), during a period of 36 months. Nodules resembling ectopic adrenal tissue from eleven patients (2.7%) were removed and the histopathological examination was performed using hematoxylin-eosin staining.

RESULTS

Ectopic adrenal cortical tissues were found in eight male patients (2%), located within the distal end of the spermatic cord. Macroscopically, the nodules were round to oval in shape, 1 to 5 mm in diameter, and bright yellow to orange in colour. Microscopically, they had three layers of adrenal cortex surrounded by a fibrous capsule and none contained any medulla. Hyperplasia or neoplastic changes were not detected, and no fetal cortex was identified.

CONCLUSIONS

It is important for surgeons to be conscious of the possibility that a nodule along the spermatic cord may be the ectopic adrenal cortical tissue. As they are associated with hyperplasia and neoplastic change, removal of ectopic adrenal cortical tissue is warranted whenever it is encountered, but a routine search for them is not mandatory.