The Relative Prevalence of Testicular Adrenal Rest Tumors in Fewer Than 20-Years-Old Boys With Congenital Adrenal Hyperplasia



Moadab MH^{1, 2} ; Hashemipour M^{1, 2} ; Azadi M³ Show Affiliations
Source: Journal of Isfahan Medical School Published:2014

Abstract

Background: Testicular adrenal rest tumor (TART) is the presence of unspecified adrenocortical cells in the testis of patients with congenital adrenal hyperplasia (CAH) and is similar to the hyperplastic adrenal glands. These tumors are usually benign; but, due to the tumor site in testicles, can lead to seminiferous tubule obstruction, gonadal dysfunction and infertility. Therefore, early diagnosis and treatment of tumors is important. This study aimed to determine the relative frequency of testicular adrenal rest tumor in children with congenital adrenal hyperplasia. Methods: This descriptive study was performed on 44 boys with congenital adrenal hyperplasia at the age of fewer than 20 years. Height, weight and blood pressure were measured; also, exact examination of testis and scrotum was done to diagnose palpable masses. For all patients, ultrasound of testis was performed by an experienced radiologist. Assessment of patients was based on height, weight and serum level of 17–hydroxy progesterone. Findings: Testicular adrenal rest tumor was reported in 2 patients (4.5%) that in one of them, bilateral tumors were reported in the upper pole of both testes. The other tumor was visible in the mediastinum of left testis. Both patients had types of salt loss, were in the age group of 15-20 years, were under hormonal control and appropriate treatment, and none of them had impaired gonadal function. The average tumor size was 14 mm. Palpable mass was not found in any of the patients. Serum levels of 17-hydroxyprogesterone was less in patients with testicular adrenal rest tumor than the others. Conclusion: The age group of the 2 boys with testicular adrenal rest tumor can show the correlation between duration of disease and the prevalence of the tumor. Examination has not enough accuracy to detect tumor and ultrasound is recommended for all the patients to be performed periodically. © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved.