J Korean Soc Radiol.  2014 Dec;71(6):324-328. 10.3348/jksr.2014.71.6.324.

Ultrasound Follow-Up of Testicular Adrenal Rest Tumors with Congenital Adrenal Hyperplasia: Report of Three Cases

• Cho JY
• Kim DW
• Yoon SK
• Nam KJ

• KMID: 1801557
• DOI: http://doi.org/10.3348/jksr.2014.71.6.324

Abstract

While testicular adrenal rest tumor is generally a rare intratesticular tumor, it is frequent in patients with congenital adrenal hyperplasia. The tumors are diagnosed and followed up by ultrasound examination because these tumors are non-palpable and symptomless in most cases and always benign. Ultrasound imaging features change depending on how congenital adrenal hyperplasia is controlled. We herein report three cases of testicular adrenal rest tumors with different usual and unusual imaging findings and follow-up imaging. Patient 1 was a 14-year-old boy who presented with poor compliance to medication. Patient 2 and 3 were a 10-year-old and 13-year-old boy who presented with precocious puberty and short stature, respectively. Ultrasound examinations demonstrated oval hypoechoic masses and irregular speculated hyperechoic masses in the testes and different serial imaging findings.

MeSH Terms

Adolescent
Adrenal Hyperplasia, Congenital*
Adrenal Rest Tumor*
Child
Compliance
Follow-Up Studies*
Humans
Male
Puberty, Precocious
Testis
Ultrasonography*

Figure

• 

  Fig. 1 Ultrasound (US) images of testicular adrenal rest tumors in a 14-year-old boy. A. Gray-scale US shows three well defined oval hypoechoic masses with no posterior acoustic shadowing around the mediastinum of the left testis. B. Color Doppler US shows nodular vascularity in peripheral portion of the masses. C. On US performed 4 years later, the masses decrease in size. However, ill-defined hyperechoic lesions (arrows) surrounding the masses develop.

• 

  Fig. 2 Ultrasound (US) images of testicular adrenal rest tumors in a 10-year-old boy. A. Gray-scale US shows a small well defined oval hypoechoic mass with no posterior acoustic shadowing in the right mediastinum testis. B. Follow-up US 6 months later shows complete resolution of the previous mass. C. Follow-up color Doppler US 23 months later shows newly well defined oval hypoechoic masses with nodular vascularity developed in the mediastinum testis.

• 

  Fig. 3 Ultrasound (US) images of testicular adrenal rest tumors in a 13-year-old boy. A. Gray-scale US shows an irregular speculated hyperechoic mass (arrows) around the mediastinum testis without posterior acoustic shadowing and small oval well defined hypoechoic mass (arrowheads) adjacent to main mass. B. Color Doppler US shows increased nodular vascularity in the mass. C. Follow-up US 6 months later shows no change in the size and shape of the main mass, but complete resolution of the small masses adjacent to main mass.

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