Presentation
Underlying congenital adrenal hyperplasia, on steroid replacement but non-compliant.
Patient Data
Bilateral testes are not enlarged. However, there are multiple bilateral nodular testicular lesions with central hyperechogenicity and peripheral hypoechoic rim. These aforementioned testicular lesions are eccentrically located, adjacent to the rete testis, no increased vascularity.
Case Discussion
Serum 17 OH-Progesterone was markedly elevated 771.0 nmol/L (Normal adult males : 0.61 - 4.24 nmol/L). Differential diagnosis of bilateral testicular lesions include:
In view of patient's underlying congenital adrenal hyperplasia on steroid replacement with non-compliance, the sonographic findings are suggestive of testicular adrenal rest tumors (TARTs).