Testicular adrenal rests
Updates to Article Attributes
Testicular adrenal rests are a rare cause of a testicular mass.
Terminology
Testicular adrenal rests can be known by a variety of terms 2:
- testicular adrenal rest tumour (TART)
- testicular adrenal rest tissue
- testicular tumour of the adrenogenital syndrome
- testicular adrenal-like tissue
Epidemiology
Can be found in the testis and surrounding tissues in 7.5-15% of newborns and ~1.5% of adults.
Clinical presentation
Usually, adrenal rests are asymptomatic. If these cells are exposed to elevated levels of adrenocorticotropic hormone, they can enlarge to form masses. They can be clinically identified inare associated with patients with congenital adrenal hyperplasia and rarely in patients with Cushing syndrome.
Pathology
Aberrant adrenal rests represent collections of cells that have become trapped within the developing gonad during fetal development. TheyThe rests are usually less than 5 mm.
Radiographic features
Ultrasound
As with evaluatingevaluation of other testicular pathology, ultrasound is the modality of choice.
The sonographic appearance of adrenal rests is variable, with some series describing predominantly hypoechoic masses and others reporting heterogeneously hyperechoic masses with shadowing. Lesions are typically multiple, bilateral, and eccentrically located, usually within the mediastinum testis.
Treatment and prognosis
It is important to suggest this in the differential diagnosis in the appropriate setting as they are benign lesions and unnecessary orchiectomy can be avoided. Appropriate hormone serum bloodwork can help secure the diagnosis.
Treatment with glucocorticoid replacement therapy results in stabilisation or regression of the masses.
Differential diagnoses
-</ul><h4>Epidemiology</h4><p>Can be found in the testis and surrounding tissues in 7.5-15% of newborns and ~1.5% of adults.</p><h4>Clinical presentation</h4><p>Usually, adrenal rests are asymptomatic. If these cells are exposed to elevated levels of adrenocorticotropic hormone, they can enlarge to form masses. They can be clinically identified in patients with <a href="/articles/congenital-adrenal-hyperplasia">congenital adrenal hyperplasia</a> and rarely in patients with <a href="/articles/cushing-syndrome">Cushing syndrome</a><a href="/articles/cushing-syndrome">. </a></p><h4>Pathology</h4><p>Aberrant adrenal rests represent collections of cells that have become trapped within the developing gonad during fetal development. They are usually less than 5 mm.</p><h4>Radiographic features </h4><h5>Ultrasound</h5><p>As with evaluating other testicular pathology, ultrasound is the modality of choice.</p><p>The sonographic appearance of adrenal rests is variable, with some series describing predominantly hypoechoic masses and others reporting heterogeneously hyperechoic masses with shadowing. Lesions are typically multiple, bilateral, and eccentrically located, usually within the <a href="/articles/mediastinum-testis">mediastinum testis</a>.</p><h4>Treatment and prognosis</h4><p>It is important to suggest this in the differential diagnosis in the appropriate setting as they are benign lesions and unnecessary orchiectomy can be avoided. Appropriate hormone serum bloodwork can help secure the diagnosis.</p><p>Treatment with glucocorticoid replacement therapy results in stabilisation or regression of the masses.</p><h4>Differential diagnoses</h4><ul>- +</ul><h4>Epidemiology</h4><p>Can be found in the testis and surrounding tissues in 7.5-15% of newborns and ~1.5% of adults.</p><h4>Clinical presentation</h4><p>Usually, adrenal rests are asymptomatic. If these cells are exposed to elevated levels of adrenocorticotropic hormone, they can enlarge to form masses. They are associated with patients with <a href="/articles/congenital-adrenal-hyperplasia">congenital adrenal hyperplasia</a> and rarely in patients with <a href="/articles/cushing-syndrome">Cushing syndrome</a><a href="/articles/cushing-syndrome">. </a></p><h4>Pathology</h4><p>Aberrant adrenal rests represent collections of cells that have become trapped within the developing gonad during fetal development. The rests are usually less than 5 mm.</p><h4>Radiographic features </h4><h5>Ultrasound</h5><p>As with evaluation of other testicular pathology, ultrasound is the modality of choice.</p><p>The sonographic appearance of adrenal rests is variable, with some series describing predominantly hypoechoic masses and others reporting heterogeneously hyperechoic masses with shadowing. Lesions are typically multiple, bilateral, and eccentrically located, usually within the <a href="/articles/mediastinum-testis">mediastinum testis</a>.</p><h4>Treatment and prognosis</h4><p>It is important to suggest this in the differential diagnosis in the appropriate setting as they are benign lesions and unnecessary orchiectomy can be avoided. Appropriate hormone serum bloodwork can help secure the diagnosis.</p><p>Treatment with glucocorticoid replacement therapy results in stabilisation or regression of the masses.</p><h4>Differential diagnoses</h4><ul>
Unable to process the form. Check for errors and try again.