The Obscured Bilateral Testicular Tumors: Is It Adrenal Rest Tumors or Leydig Cell Tumors

Abstract

A young male presented with infertility and found to have bilateral testicular masses with obscured past history of Congenital Adrenal Hyperplasia (CAH) since childhood. The differential diagnosis of bilateral testicular masses includes: Adrenal Rest tumors, Leydig cell tumors and germ cell tumors. A battery of biochemical investigations in addition to surgical exploration are needed to reach to the final diagnosis. However, differentiating Leydig cell tumors from the tumors of the adrenogenital syndrome can be difficult and need an alert urologist with collaboration of pathologist and endocrinologist.