Testicular adrenal rest tumor (TART)

Case contributed by Dr Ammar Ashraf

Presentation

Known case of congenital adrenal hyperplasia (positive mutation in the CYP21A2 gene) with poor compliance to medical treatment.

Patient Data

Age: 16 years
Gender: Male
Ultrasound

Average size testicles with a focal, irregular, eccentric, hypoechoic lesion adjacent to the mediastinum testis in both testicles. No mass effect, narrowing or distortion is seen in the testicular vessels traversing through these lesions.

A well-defined eccentric lesion is seen adjacent to mediastinum testis in both testicles. These lesions are isointense on T1 and hypointense on T2-weighted images to the testicular parenchyma. No restricted diffusion is seen in these lesions. These lesions show moderate enhancement (more than the normal testicular parenchyma) on post contrast images.

X-ray

8 years ago

The bone age matches the reference standard of 14 years with a standard deviation of +/-12 months (Greulich and Pyle). (At that time, the patient's exact chronological age was 8 years 2 months).

Case Discussion

Bilateral testicular lesions:

 

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Case information

rID: 89425
Published: 9th May 2021
Last edited: 13th May 2021
System: Urogenital
Inclusion in quiz mode: Included
Institution: Ministry of national guard health affairs

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