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Fertil Steril. 2008 Mar;89(3):597-601. Epub 2007 Jun 4.

Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia can cause severe testicular damage.

Author information

1
Department of Paediatric Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. h.claahsen@cukz.umcn.nl

Abstract

OBJECTIVE:

To evaluate the histological features of testicular tumors and residual testicular parenchyma in male patients with congenital adrenal hyperplasia (CAH) and longstanding bilateral testicular adrenal rest tumors (TART).

DESIGN:

Descriptive study.

SETTING:

University medical center in the Netherlands.

PATIENT(S):

Seven male patients who had CAH with longstanding bilateral TART and who were treated with testis-sparing surgery.

INTERVENTION(S):

Enucleation of TART and taking biopsies of the surrounding testicular parenchyma.

MAIN OUTCOME MEASURE(S):

Description of the histological features of TART and residual testicular parenchyma.

RESULT(S):

All tumors had a similar histological appearance, with sheets of polygonal cells separated by dense fibrous tissue with focal lymphocytic infiltrates and without Reinke crystals. All biopsies showed a decrease in tubular diameter with peritubular fibrosis and, in four patients, tubular hyalinization. The germinative layer showed decreased spermatogenesis and reduced Johnsen scores.

CONCLUSION(S):

Testicular adrenal rest tumors can lead to end-stage damage of testicular parenchyma, most probably as a result of longstanding obstruction of the seminiferous tubules. Therefore, treatment at an early stage is advised.

[Indexed for MEDLINE]

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