For citation: El-Sharkawy MS. Testicular Adrenal Rest Tumors: Sonographic and Magnetic Resonance Imaging Characteristics of Its Different Stages. International Journal of Biomedicine. 2025;15(1):55-57. doi:10.21103/Article15(1)_RA8
Originally published March 5, 2025
Testicular adrenal rest tumors (TARTs) are benign lesions that occur in a high percentage of patients with congenital adrenal hyperplasia and are characterized by the deficiency of adrenocortical enzymes, particularly 21-hydroxylase. On imaging, these give different patterns of uncommonly diagnosed focal testicular lesions that can allow differentiation from other focal testicular lesions, particularly germ cell tumors. Progression of the disease reflects characteristic and diagnostic appearance on sonography and magnetic resonance imaging. Awareness of these characteristics in imaging is necessary to avoid unnecessary surgery in the early stages and avoid confusion with other focal testicular lesions, particularly germ cell tumors. This paper reviews serial sonographic and MRI diagnostic features at different stages of TARTs to allow diagnosis and monitor response to treatment.
- Avila NA, Shawker TS, Jones JV, Cutler GB Jr, Merke DP. Testicular adrenal rest tissue in congenital adrenal hyperplasia: serial sonographic and clinical findings. AJR Am J Roentgenol. 1999 May;172(5):1235-8. doi: 10.2214/ajr.172.5.10227495. PMID: 10227495.
- Strauss S, Gottlieb P, Kessler A, Graif M, Heyman Z, Manor H. Non-neoplastic intratesticular lesions mimicking tumour on ultrasound. Eur Radiol. 2000;10(10):1628-35. doi: 10.1007/s003300000464. PMID: 11044937.
- Wang Z, Wang R, Wang X, Zheng S, Li M, Yu Y, Liu Z, Sun S, Zhan W. Infertility risk assessment with ultrasound in congenital adrenal hyperplasia male patients. Sci Rep. 2024 May 27;14(1):12058. doi: 10.1038/s41598-024-62954-8. PMID: 38802468; PMCID: PMC11130187.
- Mansoor NM, Huang DY, Sidhu PS. Multiparametric ultrasound imaging characteristics of multiple testicular adrenal rest tumours in congenital adrenal hyperplasia. Ultrasound. 2022 Feb;30(1):80-84. doi: 10.1177/1742271X21989081. Epub 2021 Feb 10. PMID: 35173782; PMCID: PMC8841942.
- Stikkelbroeck NM, Suliman HM, Otten BJ, Hermus AR, Blickman JG, Jager GJ. Testicular adrenal rest tumours in postpubertal males with congenital adrenal hyperplasia: sonographic and MR features. Eur Radiol. 2003 Jul;13(7):1597-603. doi: 10.1007/s00330-002-1786-3. Epub 2003 Jan 18. PMID: 12835972.
- Claahsen-van der Grinten HL, Hermus AR, Otten BJ. Testicular adrenal rest tumours in congenital adrenal hyperplasia. Int J Pediatr Endocrinol. 2009;2009:624823. doi: 10.1155/2009/624823. Epub 2009 Feb 26. PMID: 19956703; PMCID: PMC2777016.
- Stikkelbroeck NM, Hermus AR, Suliman HM, Jager GJ, Otten BJ. Asymptomatic testicular adrenal rest tumours in adolescent and adult males with congenital adrenal hyperplasia: basal and follow-up investigation after 2.6 years. J Pediatr Endocrinol Metab. 2004 Apr;17(4):645-53. doi: 10.1515/jpem.2004.17.4.645. PMID: 15198296.
- Philips S, Nagar A, Dighe M, Vikram R, Sunnapwar A, Prasad S. Benign non-cystic scrotal tumors and pseudotumors. Acta Radiol. 2012 Feb 1;53(1):102-11. doi: 10.1258/ar.2011.110185. Epub 2011 Oct 24. PMID: 22025740.
- Deshpande SS, Shetty D, Saifi S. Sonographic Appearance of Testicular Adrenal Rest Tumour in a Patient with Congenital Adrenal Hyperplasia. Pol J Radiol. 2017 Sep 15;82:526-529. doi: 10.12659/PJR.902013. PMID: 29662583; PMCID: PMC5894002.
- Reisch N, Scherr M, Flade L, Bidlingmaier M, Schwarz HP, Müller-Lisse U, Reincke M, Quinkler M, Beuschlein F. Total adrenal volume but not testicular adrenal rest tumor volume is associated with hormonal control in patients with 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2010 May;95(5):2065-72. doi: 10.1210/jc.2009-1929. Epub 2010 Feb 26. PMID: 20190160.
Download Article
Received January 9, 2025.
Accepted February 17, 2024.
©2025 International Medical Research and Development Corporation.