Testicular adrenal rest tissue in a patient with classical congenital adrenal hyperplasia: color Doppler findings

Abstract

Congenital adrenal hyperplasia (also known as congenital adrenogenital syndromes) refers to a group of autosomal recessive diseases characterized by altered cortisol production, which may be associated with aldosterone deficiency. The absence of cortisol synthesis stimulates corticotropin production by the adrenal cells and the accumulation of cortisol precursors, which will be diverted for the production of sex hormones. In affected males, ectopic adrenal tissue frequently develops, usually at the testicular level. This tissue is absolutely identical to that of the adrenal gland itself, and its functionality can be stimulated by ACTH and suppressed with glucocorticoid therapy. The authors report the case of a male patient with classic congenital adrenal hyperplasia, who was referred to our staff for evaluation of bilateral testicular tenderness and enlargement. Color Doppler sonography revealed mild enlargement of both gonads, widespread disruption of the testicular echostructure, and hypervascularization. Two months later, when the underlying disease had been controlled, repeat color Doppler ultrasonography revealed markedly decreased vascularity, although no change was noted on the B-mode examination. The color Doppler findings thus represent an early indicator of response to treatment.

Plasmacytoma of the testis in a patient with previous multiple myeloma: sonographic appearance

“…Ultrasound detected a gradual increase in testicular volume; however, the testicle maintains a relatively homogeneous echogenicity, unlike in other testicular malignancies [8]. The color Doppler examination shows increased vascularity, but this is often more modest than in other testicular tumors [9] and more similar to that of pseudotumors [10]. Sheath localizations are not described, unlike other testicular cancers [9,11].…”

Testicular Adrenal Rest Tumors (TARTS) With Unusual Histological Features in Congenital Adrenal Hyperplasia (CAH)

“…Color Doppler may be helpful in establishing the diagnosis. 5 Our patient was not followed-up strictly – he followed consecutive replacement therapy until his 18th year. After that he interrupted therapy at his own discretion.…”

Sonographic features of the testicular adrenal rests tumors in patients with congenital adrenal hyperplasia: a single-center experience and literature review

“…In the literature since 1990, 23 articles were found to have described the sonographic features of TART [2,7,11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. One hundred twenty-three patients with a total of 223 testicular lesions were collected.…”