Fact-sheet: Testicular adrenal rest tumors
Updated on 08/06/2020 at 3:27 PM
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Definition
Intratesticular adrenal rest tumors are benign testicular tumors occurring in ACTH hypersecretion syndromes, most often in the setting of congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
Clinical features
Generally, young men
Clinical discovery on palpation or incidental finding on ultrasound
Ultrasound
Confluent hypoechoic masses, often bilateral, located in the region of the testicular hilum
At a late stage: highly suggestive attenuating appearance
Color Doppler: regular vascular architecture
Management
They generally regress or stabilize under glucocorticoid replacement therapy.
They may sometimes progress, raising the question of their nature. Biopsy or spermatic vein sampling are not reliable. Follow-up or, as a last resort, orchidectomy establishes the diagnosis