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J R Soc Med 2005;98:295
doi:10.1258/jrsm.98.6.295
© 2005 Royal Society of Medicine

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J R Soc Med 2005;98:295
© 2005 The Royal Society of Medicine

Letters

Ganglioneuromas in the adult scrotum

Ali Thwalni Ravi Kumar   Iqbal Shergill

St Bartholomew's Hospital, London, UK

Reporting on a patient with paratesticular ganglioneuromas Mr Hanna and his colleagues (February 2005 JRSM1) recommend imaging of the retroperitoneum in such cases because of the common embryological origin of scrotum and retroperitoneum. We disagree with their embryology. The scrotum develops as follows: between the sixth and eighth weeks of development, a pair of swellings (cloacal folds) appear on either side of the cloacal membrane. The folds meet anterior to this membrane to form the genital tubercle.2 The peritoneum divides the cloacal membrane into a urogenital membrane and an anal membrane. This also separates the cloacal fold into a urethral fold and an anal fold. Then, a pair of labia-scrotal swellings appear, which ultimately develop into a male scrotum.3 By contrast, the ganglionic crest will be constituted, in the mesoblast space, from the ectoblast, from each side of the neural tube on the whole length of the notochord, as metamerized bands to give the matrix of the sympathetic (from which paratesticular ganglioneuromas arise) and parasympathetic nervous system.

REFERENCES

  1. Hanna SJ, Muneer A, Cohill SB, Miller MAW. Ganglioneuromas in the adult scrotum. J R Soc Med2005; 98:63[Free Full Text]

  2. Larssen WJ. Essentials of Human Embryology.2004 : 276

  3. Dr Mark Hill. Development of the Kidneys and Reproductive System. UNSW Embryology, 2004 [embryology.med.unsw.edu.au]. Accessed 4 April 2005


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