Abstract
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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References
Barwick TD, Malhotra A, Webb JAW, Savage MO, Reznek RH (2005) Embryology of the adrenal glands and its relevance to diagnostic imaging. Clin Radiol 60:953–959
Mares AJ, Shkolnik A, Sacks M, Feuchtwanger MM (1980) Aberrant (ectopic) adrenocortical tissue along the spermatic cord. J Pediatr Surg 15:289–292
Savaş Ç, Çandır Ö, Bezir M, Çakmak M (2001) Ectopic adrenocortical nodules along the spermatic cord of children. Int Urol Nephrol 32:681–685
Benvenga S, Smedile G, Giudice FL, Trimarchi F (1999) Testicular adrenal rests: evidence for luteinizing hormone receptors and for distinct types of testicular nodules differing for their autonomization. Eur J Endocrinol 141:231–237
Sullivan JG, Gohel M, Kinder RB (2005) Ectopic adrenocortical tissue found at groin exploration in children: incidence in relation to diagnosis, age and sex. BJU Int 95:407–410
Okur H, Küçükaydın M, Kazez A, Kontaş O (1995) Ectopic adrenal tissue in the inguinal region in children. Pediatr Pathol Lab Med 15:763–767
Ventura L, Peocata P, Hind A, Greco I, Ventura T (1998) Ectopic adrenal tissue in the spermatic cord. Case report and review of the literature. Arch Ital Urol Nephrol LXX:15–18
Habuchi T, Mizutani Y, Miyakawa M (1992) Ectopic aberrant adrenals with epididymal abnormality. Urology 39:251–253
Oguzkurt P, Öz S, Kayaselçuk F (2002) Ectopic adrenal tissue: an incidental finding during inguinoscrotal operations in children. Hernia 6:62–63
Dahl EV, Bahn RC (1962) Aberrant adrenocortical tissue near the testis in human infants. Am J Pathol 40:587–598
Schechter DC (1968) Aberrant adrenal tissue. Ann Surg 167:421–426
Anderson JR, McLean Ross AH (1980) Ectopic adrenal tissue in adults. Postgrad Med J 56:806–808
Souverijns G, Peene P, Keuleers H, Vanbockrijk M (2000) Ectopic localization of adrenal cortex. Eur Radiol 10:1165–1168
Drews U (2000) Urogenital system. In: Drews U (ed) Color atlas of embryology. Turkish version. Thieme/Nobel Tip Kitabevleri, Istanbul, pp 336–337
Silver RI, Docimo SG (1999) Cryptorchidism. In: Gonzales ET, Bauer SB (eds) Pediatric urology practice. Lippincott Williams & Wilkins, Philadelphia, pp 499–523
Raz E (2004) Guidance of primordial germ cell migration. Curr Opin Cell Biol 16:169–173
Kierszenbaum AL, Tres LL (2001) Primordial germ cell-somatic cell partnership: a balancing cell signaling act. Mol Reprod Dev 60:277–280
Doitsidou M, Reichman-Fried M, Stebler J, Köprunner M, Dörries J, Meyer D, Esguerra CV, Leung TC, Raz E (2002) Guidance of primordial germ cell migration by the chemokine SDF-1. Cell 111:647–659
Robinson LLL, Gaskell TL, Saunders PTK, Anderson RA (2001) Germ cell specific expression of c-kit in the human fetal gonad. Mol Hum Reprod 7:845–852
Wylie C (1999) Germ cells. Cell 96:165–174
Moore LA, Broihier HT, Van Doren M, Lunsford LB, Lehmann R (1998) Identification of genes controlling germ cell migration and embryonic gonad formation in Drosophila. Development 125:667–678
Acknowledgments
Authors would like to thank Prof. Dr. F. Cahit Tanyel, Assoc. Prof. Dr. Bayram Yılmaz for their critics and comments, Assoc. Prof. Dr. Neriman Colakoglu for revision of embryological information and Assist. Prof. Dr. Nural Bekiroglu for the statistical analysis of this study.
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Özel, Ş.K., Kazez, A. & Akpolat, N. Presence of ectopic adrenocortical tissues in inguinoscrotal region suggests an association with undescended testis. Pediatr Surg Int 23, 171–175 (2007). https://doi.org/10.1007/s00383-006-1826-1
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DOI: https://doi.org/10.1007/s00383-006-1826-1