Testicular adrenal rests

Case contributed by Dr Fabien Ho

Presentation

Known congenital adrenal hyperplasia, supplemented. Painless palpable testicular nodules.

Patient Data

Age: 20
Gender: Male
Ultrasound

Bilateral coarse echogenic round nodules with clear borders and mostly peripheral vessels.

MRI

Testicles have a nodular architecture, with signal isoT1 to muscle and hypoT2.

Expected testicles signal is rather hyperT2, with clear round non-nodular borders.

Case Discussion

Adrenal inclusions within testicles 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 indeed
  • bilateral and confluent nodules
  • next to testicular hilum
  • round borders, attenuating echos
  • no calcifications, non-hypervascular on color Doppler.


It is worth noting that MRI, in this case, has no diagnostic value proven. US remains the gold standard.

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Case information

rID: 63425
Published: 5th Oct 2018
Last edited: 14th Aug 2019
System: Urogenital
Inclusion in quiz mode: Included
Institution: Clinique Sainte Clotilde

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