TESTICULAR ADRENAL REST TUMORS IN PEDIATRIC WORLD: CASE REPORT AND REVIEW OF LITERATURE

Mariam Shah, Khurram Khaliq Bhinder, Zenab Farooq, Sana Sayeed

Abstract


Testicular adrenal rest tumors (TARTs) are rare benign ACTH-dependent tumors that occur in males with congenital adrenal hyperplasia (CAH) mostly in those who have defaulted treatment but can also be seen in well-controlled patients and if left untreated can destroy testicular tissue leading to infertility. Early diagnosis and treatment of tart are important for gonadal function and fertility treatment. Tarts have very characteristic ultrasound features and recognizing them avoids misdiagnosing them as malignancies, which can lead to unnecessary intervention. We describe a case of a 12-year-old boy who initially presented to our hospital for bone age assessment, followed by serial endocrine workup for congenital adrenal hyperplasia. The diagnosis of CAH was confirmed afterwards on hormonal studies showing significantly raised 17-Oh progesterone and mildly raised LH and testosterone while ACTH and HbA1c were however within normal range. Ultrasound abdomen was also performed which was unremarkable at that time. Patient again presented for bone age assessment which was more that the chronological age due to steroid therapy. Recently scrotal ultrasound was performed, there were multiple bilateral hypo-echoic heterogeneous lesions with significant internal vascularity were seen along mediastinum testis and diagnosis of rare benign deposits of TART was made in bilateral testes.


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