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Case Reports
. 2020:72:66-68.
doi: 10.1016/j.ijscr.2020.05.047. Epub 2020 May 30.

Ectopic adrenal gland in an adult inguinal hernial sac: A case report

Mersad Alimoradi  1 , Etienne El-Helou  2 , Hassan Sabra  3 , Rawan Azaki  4 , Mayssaloun Khairallah  5 , Nazem Matta  6
Affiliations
Case Reports

Ectopic adrenal gland in an adult inguinal hernial sac: A case report

Mersad Alimoradi et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: A 37-year-old male patient operated for inguinal hernia repair was found to have ectopic adrenocortical tissue in the hernial sac.

Case presentation: A 37-year-old man was admitted for bilateral inguinal hernia. An uneventful open repair was done, and the resected hernial sacs were sent to pathology. Histopathology reported the presence of adrenocortical tissue in the right inguinal hernial sac.

Discussion: Ectopic adrenocortical tissue (EACT) in the groin region is not an unusual finding in children, however, it's rarely reported in adult patients. Only 9 cases have been reported in English describing EACT in an adult's inguinal hernia. The finding can be attributed to the close proximity of the developing gonads and adrenal cortex during embryogenesis, and subsequent mechanical translocation of adrenocortical tissue during testicular descent. Some theoretical clinical implications exist for this condition, including secondary hyperplasia after adrenalectomy, adrenal insufficiency in certain situations, and possible neoplastic transformation. Generally, it is recommended that surgeons resect ectopic adrenal glands when identified intra-operatively. However, actively searching for these glands has no known benefit and carries some surgical risks, and is hence not recommended. It is reasonable as well, that clinicians keep the clinical implications of this finding in mind during future follow-ups with such patients.

Conclusion: The presence of ectopic adrenocortical tissue in inguinal hernia sacs is a rare encounter in adults. The condition can have several theoretical clinical implications that need to be considered by surgeons while assessing patients in whom this phenomenon is observed.

Keywords: Case report; Ectopic adrenocortical tissue; Inguinal hernia.

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Figures

Fig. 1
Fig. 1
Pathology pictures of the resected tissue. Adrenocortical tissue enlarged 40 times (A), Adrenocortical tissue enlarged 100 times (B), Adrenocortical tissue enlarged 400 times (C), and Hernial sac (D).
See this image and copyright information in PMC

References

    1. Mendez R., Tellado M.G., Somoza I. Ectopic adrenal tissue in the spermatic cord in pediatric patients: surgical implications. Int. Braz. J. Urol. 2006;32(2):202–207. doi: 10.1590/s1677-55382006000200013. discussion 207. - DOI - PubMed
    1. Vaos G., Zavras N., Boukouvalea I. Ectopic adrenocortical tissue along the inguinoscrotal path of children. Int. Surg. 2006;91(3):125–128. - PubMed
    1. Senescende L., Bitolog P.L., Auberger E., Zarzavadjian Le Bian A., Cesaretti M. Adrenal ectopy of adult groin region: a systematic review of an unexpected anatomopathologic diagnosis. Hernia. 2016;20(6):879–885. doi: 10.1007/s10029-016-1535-1. - DOI - PubMed
    1. Kassaby S.S., Velilla R.E., Shurbaji M.S. Adrenal cortical heterotopia in an inguinal hernia sac of an adult: a case report and literature review. Hum. Pathol.: Case Rep. 2017;8:13–15. doi: 10.1016/j.ehpc.2016.08.007. - DOI
    1. Agha R.A., Borrelli M.R., Farwana R., Koshy K., Fowler A., Orgill D.P., For the SCARE Group The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines. Int. J. Surg. 2018;60:132–136. - PubMed

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