title: Testicular adrenal rest tumours in young adult males with congenital adrenal hyperplasia: prevalence and impact on testicular function.
abstract: Testicular adrenal rest tumours (TARTs) have been described in patients with congenital adrenal hyperplasia (CAH). The aim of the study was to determine the prevalence of TARTs in patients with CAH, the associated factors and their impact on gonadal function. It is a prospective study concerning six young adult men with CAH, four cases with 21-hydroxylase deficiency and two cases with 11-hydroxylase deficiency. All patients were under glucocorticoid therapy. The mean age was 25 years (range: 20-31). All patients underwent a physical examination with testicular palpation, scrotal ultrasonography, a blood sample for serum testosterone, FSH, LH, inhibin B, ∆4-androstenedione and 17-OH-progesterone measurements and a semen analysis. Ultrasound revealed TARTs in four patients; three were bilateral. The mean tumour size was 6.3 ml (range: 0.02-14.1). The tumours were palpable in two cases. 17-OH-progesterone was <10 ng/ml in all cases. Decreased testosterone level was found in one case. The semen analysis revealed azoospermia in one case and poor semen quality in four patients. TARTs were common and associated with impaired spermatogenesis.
authors.affiliation: Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Chihaoui
authors.affiliation: Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: F
authors.initials: F
authors.lastname: Kanoun
authors.affiliation: Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: F
authors.initials: F
authors.lastname: Chaker
authors.affiliation: Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Yazidi
authors.affiliation: Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: K
authors.initials: K
authors.lastname: Bouchrit
authors.affiliation: Department of Radiology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: H
authors.initials: H
authors.lastname: Mizouni
authors.affiliation: Department of Biochemistry, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Feki
authors.affiliation: Department of Genetics, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Kharrat
authors.affiliation: Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: H
authors.initials: H
authors.lastname: Slimane
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000378:metabolism; D000312:Adrenal Hyperplasia, Congenital / Q000453:epidemiology* / Q000378:metabolism; D000314:Adrenal Rest Tumor / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000735:Androstenedione / Q000378:metabolism; D053627:Asthenozoospermia / Q000175:diagnosis / Q000453:epidemiology*; D053713:Azoospermia / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007265:Inhibins / Q000378:metabolism; D007986:Luteinizing Hormone / Q000378:metabolism; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology*; D009845:Oligospermia / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D013076:Sperm Count; D013081:Sperm Motility; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D013739:Testosterone / Q000378:metabolism; D055815:Young Adult
chemical_list: C422364:inhibin B; D013739:Testosterone; D000735:Androstenedione; D007265:Inhibins; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: Congenital adrenal hyperplasia; semen analysis; testicular adrenal rest tumours; testicular sonography