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Case Reports
. 2017 Sep 15:82:526-529.
doi: 10.12659/PJR.902013. eCollection 2017.

Sonographic Appearance of Testicular Adrenal Rest Tumour in a Patient with Congenital Adrenal Hyperplasia

Saurabh S Deshpande  1   2 , Devdas Shetty  1 , Shenaz Saifi  1
Affiliations
Case Reports

Sonographic Appearance of Testicular Adrenal Rest Tumour in a Patient with Congenital Adrenal Hyperplasia

Saurabh S Deshpande et al. Pol J Radiol. .

Abstract

Background: Testicular adrenal rest tumours (TARTs) are benign testicular masses that are found in inadequately treated patients with congenital adrenal hyperplasia (CAH). Recognizing this association and identifying characteristic ultrasound features of TARTs is important so as to avoid misdiagnosing them as malignancies, which can lead to unnecessary interventions.

Case report: We describe a case of a 9-year-old boy, with a diagnosis of CAH and precocious puberty, who was referred to our department for an ultrasound evaluation of the abdomen and scrotum. On ultrasound, there were well-defined, heterogeneous, predominantly hypoechoic, round-to-oval masses in both testes. Taking into account the presence of CAH and a typical sonographic appearance of bilateral testicular masses, a diagnosis of testicular adrenal rest tumour was made; biopsy was deferred and hormonal treatment was modified.

Conclusions: Prompt diagnosis of testicular adrenal rest tumours is essential, as it only indicates inadequate hormonal control. Moreover, it can prevent unnecessary biopsies and orchidectomies, and can maintain fertility. TARTs have a typical imaging appearance that every radiologist must be aware of.

Keywords: Adrenal Hyperplasia, Congenital; Testicular Neoplasms; Ultrasonography.

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Figures

Figure 1
Figure 1
There is a well-defined, heterogeneous, predominantly hypoechoic, round-to-oval lesion, with posterior acoustic shadowing in the medial aspect of the right testis, near the mediastinum testis, measuring approximately 1.3×1.1 cm.
Figure 2
Figure 2
There is a well-defined, heterogeneous, predominantly hypoechoic round-to-oval lesion, with posterior acoustic shadowing, in the medial aspect of the left testis, near the mediastinum testis, measuring approximately 1.5×1.2 cm.
Figure 3
Figure 3
The lesions in both testes revealed minimal internal vascularity. The rest of the testis showed normal flow.
Figure 4
Figure 4
Abdominal ultrasound did not reveal any mass lesion in the suprarenal region, ruling out adrenal gland enlargement.
See this image and copyright information in PMC

References

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