Presentation
Known congenital adrenal hyperplasia, supplemented. Painless palpable testicular nodules.
Patient Data
Age: 20 years
Gender: Male
From the case:
Testicular adrenal rests
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Bilateral coarse echogenic round nodules with clear borders and mostly peripheral vessels.
From the case:
Testicular adrenal rests
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Testes have a nodular architecture, with signal isoT1 to muscle and hypoT2.
Expected testes signal is rather hyperT2, with clear round non-nodular borders.
Case Discussion
Adrenal inclusions within testes are great mimics of testicular tumors.
However, helpful clues that may help to be confident in adrenal rests are:
- known history of congenital adrenal hyperplasia
- bilateral and confluent nodules
- next to testicular hilum
- round borders, attenuating echoes
- no calcifications, non-hypervascular on color Doppler
It is worth noting that MRI, in this case, has no proven diagnostic value. US remains the gold standard.
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