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Testicular adrenal rest tumors
Azucena Lirio Armas-Alvarez1, Antonio Santiago Salinas-Sánchez1, Manuel Atienzar-Tobarra2
1Department of Urology, University Hospital of Albacete, Albacete, Spain.
Revista Internacional De Andrologia
|October 10, 2018
Summary
Congenital adrenal hyperplasia can cause testicular adrenal rest tumors in adults. Glucocorticoid treatment effectively reduced tumor size and alleviated pain in a 29-year-old patient.
Area of Science:
- Endocrinology
- Urology
- Oncology
Background:
- Congenital adrenal hyperplasia (CAH) is a group of genetic disorders affecting the adrenal glands.
- Testicular adrenal rest tumors (TARTs) are benign growths associated with CAH, often presenting in adolescents and adults.
- TARTs can cause testicular pain, masses, and infertility, complicating CAH management.
Observation:
- A 29-year-old male with CAH presented with testicular pain, bilateral testicular masses, and oligospermia.
- Ultrasonography revealed heterogeneous, hypoechoic lesions with irregular borders and vascularity in both testes.
- Seric tumor markers were negative, and perioperative biopsy suggested TARTs.
Findings:
- Perioperative biopsy confirmed testicular adrenal rest tumors, leading to the cessation of planned orchiectomy.
- High-dose glucocorticoid therapy was initiated for the patient.
- Treatment resulted in a decrease in testicular mass size and significant alleviation of testicular pain.
Implications:
- This case highlights the importance of considering TARTs in adult CAH patients with testicular abnormalities.
- Glucocorticoid therapy is an effective non-surgical management option for TARTs, preserving testicular function.
- Early diagnosis and appropriate management of TARTs are crucial for improving fertility and quality of life in CAH patients.
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