Ectopic Adrenal Cortical Tissue Research Articles

Management of pediatric vanishing testes syndrome based on pathological diagnosis: a single-center retrospective study

This study aims to explore the optimal management strategy for pediatric vanishing testes syndrome (VTS) based on pathological characteristics. We retrospectively analyzed clinical data and pathological results of children with unilateral VTS who underwent surgical treatment at our center from July 2012 to July 2023. The children were categorized into the testicular excision group and testicular preservation group based on the surgical approach. Clinical characteristics and outcomes were compared between the two groups. Pathological examination results of excised testicular tissues were collected and analyzed, and long-term follow-up was conducted. A total of 368 children were included in this study. The age of the children at the time of surgery was 27 months (range, 6–156). Among them, 267 cases (72.6%) had VTS on the left side, and 101 cases (27.4%) on the right side. There were no statistically significant differences (P > 0.05) in age, affected side, contralateral testicular hypertrophy (CTH), testicular location, and preferred surgical incision between the testicular excision group (n = 336) and the testicular preservation group (n = 32). In the preservation group, two children experienced scrotal incision infections, showing a statistically significant difference compared to the excision group (P < 0.05). Pathological examination of excised tissues revealed fibrosis as the most common finding (79.5%), followed by vas deferens involvement (67%), epididymis involvement (40.5%), calcification (38.4%), and hemosiderin deposition (17.9%). Seminiferous tubules (SNT) was present in 24 cases (7.1%), germ cells (GC)in 15 cases (4.5%), and ectopic adrenal cortical tissue(EACT) in 1 case (0.3%). VTS belongs to a type of non-palpable testes (NPT) and requires surgical exploration. Considering the risk of scrotal incision infection after preserving atrophic testicular remnants and the unpredictable malignant potential, we recommend excision.

Incidental ectopic adrenal cortical tissue: Retrospective analysis of 16 patients

To evaluate ectopic adrenal cortical tissue (EACT) and identify clinical, pathological and radiological aspects. Retrospective review of pathology reports in a single tertiary institution between 2010 and 2020 was conducted. Patients diagnosed with EACT were included for analysis. Demographic characteristics, accompanying pathologies and clinicopathological and radiological findings of these patients were analyzed. There was a total of 17 patients in the cohort. Fifteen were boys and 2 were adults (1 male). The mean diameter of the EACT nodule was 0.25cm (range 0.2-0.5cm). All EACTs were incidentally diagnosed. Seven EACTs were diagnosed during an inguinal hernia repair, 6 during orchidopexy, 1 during partial orchiectomy, 2 during orchiectomy and 1 during hysterectomy and bilateral salpingoophorectomy due to uterine prolapse. EACT is a rare entity that is mostly found incidentally during inguinoscrotal interventions. Radiological discrimination of EACT may not be easy and thus, not detected prior to surgery. Clinical significance of EACT is not very well understood, however it tends to be a benign pathology. Although it is more commonly found in children, adults may present with EACT, as well. A tiny yellowish nodule detected in the inguinoscrotal region should be suspected for EACT by pediatric urologists, surgeons, and pathologists.

Androgen-Secreting Tumor with Oncocytic Features and Myelolipoma Arising from Ectopic Adrenal Cortical Tissue Located in Broad Ligament of the Uterus: Too Rare a Disease!

Hirsutism or excess growth of androgen-dependent hairs in a male pattern distribution associated with menstrual irregularities is frequently encountered in clinical practice. Polycystic ovary syndrome and non-classic congenital adrenal hyperplasia are the common underlying causes; androgen-secreting ovarian or adrenal neoplasms also need to be ruled out in appropriate settings, particularly in presence of virilization and grossly elevated circulatory androgens. Elevated 17α-hydroxyprogesterone (17-OH-P), though highly suggestive of congenital adrenal hyperplasia, is not specific for the disease, and grossly elevated values are occasionally encountered in androgen-producing tumors. Ectopic adrenocortical tissue or adrenal rest at times may undergo tumor formation and become hormonally active. In this article, androgen-secreting tumor of adrenal rest located in broad ligament of the uterus is reported as the underlying cause of severe hyperandrogenism in a young lady who was initially diagnosed with simple virilizing form of congenital adrenal hyperplasia due to 21 hydroxylase deficiency following elevated circulatory 17-OH-P levels.

Differentiating Intrarenal Ectopic Adrenal Tissue From Renal Cell Carcinoma in the Kidney.

Adrenal rest (AR) is the presence of ectopic adrenal cortical tissue, often identified incidentally during autopsy (20% of postmortem examination). In the kidney, AR can be found in 6% of the general population. Ectopic adrenal tissue is of no functional significance but may in some cases, pose a diagnostic challenge for the pathologist, especially in the context of renal clear cell renal cell carcinoma (RCC) and small needle biopsies. To investigate the utility of immunohistochemical stains in distinguishing AR from RCC. Archival cases of AR, in our institution, were reviewed and compared with a cohort of RCC cases using a panel of immunohistochemical stains, including PAX2, PAX8, calretinin, and inhibin. Nine of 10 (90%) cases of AR showed positive staining for inhibin and negative staining for calretinin, PAX2 and PAX8. One AR case was positive for PAX2 and PAX8 in addition to inhibin. All (100%) RCC cases were positive for PAX2 and PAX8, but negative for inhibin and calretinin. A panel of PAX2, PAX8 and inhibin may be useful markers for distinguishing AR from RCC. Calretinin was noncontributory in our study.

Adrenal cortical heterotopia in an inguinal hernia sac of an adult: A case report and literature review

Ectopic adrenal cortical tissue is not an infrequent incidental finding during abdominal and inguinal operations in infants; however, it is a rare finding in adults with only a few case reports described in the literature. We report a case of adrenal heterotopia as an incidental finding in a hernia sac from a 56year-old man. We review the literature and discuss the importance of recognizing this rare finding.

Pediatric spinal adrenocortical carcinoma

A 5-month-old girl was found on magnetic resonance imaging to have a heterogeneously enhancing conus region mass. At surgery, an extramedullary, intradural mass was resected. Pathology confirmed a diagnosis of adrenocortical carci- noma. The neoplasm originated from ectopic adrenal cortical cell rests in the spine. Ectopic adrenal cortical tissue in the spinal canal is extremely rare. This is only the ninth reported case of an adrenocortical neoplasm arising as a primary tumor in the cen- tral nervous system.

A Rare Case of Ectopic Adrenal Tissue in the Left Ovary in a Patient with a Granulosa-Cell Tumor of the Right Ovary

Abstract Background: Ectopic adrenal tissue is usually seen incidentally during pediatric inguinal hernia operations, but it is uncommon in the adult female pelvis. Case: A 50-year-old woman who had had menorrhagia, dyspareunia, and abdominal distention for 12 months was hospitalized. Ultrasound examination revealed a mass containing cystic and solid regions at the right adnexa. The patient had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy because malignant stromal tumor was found at frozen section. The final pathologic diagnosis of the case was granulosa cell tumor on the right ovary and ectopic adrenal cortical tissue in the left ovary. Results: Her postoperative course was uneventful, and she was discharged after her 7th day postoperative. Conclusions: The germ and adrenal gland cells migrate together during the embryologic period. The coexistence of adrenal gland and granulosa cell tumor may be due to this migration theory. (J GYNECOL SURG 28...

Ectopic Adrenocortical Tissue: An Incidental Finding During Inguinal Surgery in Children

Adrenal rests are usually unrecognized during operation, and the incidence of ectopic adrenal cortical tissue in pediatric patients during inguinal surgery procedures is unknown. We performed 3028 groin surgical explorations in 2680 patients aged 1 month to 17 years. Ectopic adrenal tissue was found in 69 inguinal operations (2.2%): 37 during 1.524 orchiopexy (2.4%), 23 during 1.115 herniectomy (2.0%), and 9 during 389 hydrocoela operation (2.3%). Statistically there were no significant differences among those three groups. No adrenal rests were detected in females. Although a few reported cases with hormonal activity of ectopic adrenocortical tissue (EACT), the recommendation is to remove them if found.

Ectopic Adrenal Cortex Tissue: An Incidental Finding during Inguinoscrotal Operations in Pediatric Patients

Objective: The aim of the present study was to assess the occurrence of ectopic remnants of adrenal cortex tissue encountered in pediatric patients who underwent groin surgical explorations. Materials and Methods: We studied 1,862 patients with groin surgical explorations during a period of 12 consecutive years (1995–2006). Nodules resembling ectopic adrenal tissue were removed and the histopathological examination was performed using hematoxylin and eosin staining. Results: We found ectopic adrenal cortex tissue along the spermatic cord in 31 patients in 1,862 groin surgical explorations, an overall incidence of 1.66%. None were found in females. Of the 31 cases, 20 were diagnosed as having undescended testes, 8 communicating hydrocele, and 3 inguinal hernia. Median age at diagnosis was 6.5 years (range 2–14). The nodules were found located along the spermatic cord, in the apex of the hernial sac, and between the testis and epididymis. Macroscopically, the nodules were round to oval in shape, 2–6 mm in diameter, and bright yellow to orange in color. Microscopically, they had three well-defined layers of adrenal cortex, with predominance of the zona fasciculata, surrounded by a fibrous capsule and none contained any medulla. Conclusion: Ectopic adrenal cortical tissue is a benign lesion. Although a routine search for this lesion is not indicated, it should be resected for histological analysis and differential diagnosis when it is found during a surgical procedure in this area.

Ectopic adrenal tissue: an incidental finding during inguinoscrotal operations in children.

Ectopic adrenal cortical tissue has occasionally been documented. During a period of 18 months 152 children underwent operations for common inguinoscrotal pathology. In four cases ectopic adrenocortical tissue was found as a yellow nodule along the spermatic cord or hernia sac. Surgeons can recognize and remove it without any further investigation.