The discovery of ectopic adrenal tissue in the hernial sac is very rare, and in the majority of reported cases it is in children, while it is never described in adult subjects. This could be due to a progressive previous atrophy of the ectopic tissue or to an insufficient examination of the sac removed surgically. The most frequent site of these ectopias is the kidney, adjacent to the adrenal glands. The presence of ectopic adrenal tissue is important because of its neoplastic and hyperplastic potential. We report a case of a 69-year-old male patient who underwent a surgical operation of a left inguinal hernia and that the presence of ectopic adrenal tissue was reported in the pathologist's report. Preoperative abdominal ultrasound should therefore be performed in patients destined for an inguinal hernia surgery, because also the rare existence of ectopic adrenal tissue in the hernial sac should be kept in mind. KEY WORDS: Adrenal, Adult, Ectopia, Herni sac.
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