Adrenal ectopy of adult groin region: a systematic review of an unexpected anatomopathologic diagnosis.
OBJECTIVE
Adrenal ectopy is a rare condition, caused by abnormal embryological development of the adrenal glands and testis. This anomaly is asymptomatic and is generally diagnosed in childhood. Most cases of adrenal ectopy of the groin region have been found incidentally during surgery. This review aims to evaluate the incidence of adrenal ectopy of the adult groin region, as well as its short- and long-term significance.


METHODS
A systematic literature search was performed using the EMBASE, MEDLINE, PubMed and Cochrane Central databases to identify all studies published until December 2015. Articles written in English containing the keywords: ''ectopic adrenal tissue'' or ''aberrant adrenal tissue'' or ''adrenal heterotopy'' combined with ''groin region'' or ''inguinal'' or ''testicular" or "scrotum" and "adult" were selected.


RESULTS
Fifteen articles matched the review criteria. A total of 21 cases (100 % male) were included. No cases of bilateral nodules have been reported. The mean age at diagnosis was 43.5 years old (range 19-78 years). A predominance of right-sided lesions was observed (71.4 %). The mean size reached 7.6 mm (range 2-40 mm) and hernia sacs were the most common location (47.6 %). All histological analyses of harvested tissues consisted of adrenal cortex without medulla.


CONCLUSIONS
Our results suggest that routine pathological examination of any groin tissue excised during inguinal hernia repairs is required for the diagnosis of adrenal ectopy in the groin. Although there is no current evidence that endocrine or oncologic complications can occur from excision of ectopic adrenal tissue, further confirmatory studies may be required.
Service de chirurgie digestive, Centre Hospitalier Simone-Veil, 14, rue des Saint-Prix, 95600, Eaubonne, France.
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Senescende
Service d'anatomopathologie, Centre Hospitalier Simone-Veil, 14, rue des Saint-Prix, 95600, Eaubonne, France.
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Bitolog
Service d'anatomopathologie, Centre Hospitalier Simone-Veil, 14, rue des Saint-Prix, 95600, Eaubonne, France.
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Auberger
Service de chirurgie digestive, Centre Hospitalier Simone-Veil, 14, rue des Saint-Prix, 95600, Eaubonne, France.|Laboratoire d'éthique médicale et de médecine légale, Université Paris Descartes, Paris, France.
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Zarzavadjian Le Bian
Service de chirurgie digestive, Centre Hospitalier Simone-Veil, 14, rue des Saint-Prix, 95600, Eaubonne, France. manuela.csr@hotmail.it.|Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 100 Boulevard du Général Leclerc, 92110, Clichy, France. manuela.csr@hotmail.it.
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Cesaretti
D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D002828:Choristoma / Q000473:pathology; D006119:Groin / Q000473:pathology; D006552:Hernia, Inguinal / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male
Adrenal ectopy; Adrenal gland; Adult; Groin region