title: Leydig cell tumour and giant adrenal myelolipoma associated with adrenogenital syndrome: a case report with a review of the literature.
abstract: BACKGROUND
  Male patients with congenital adrenal hyperplasia (CAH) may develop bilateral testicular adrenal rest tumours (TARTs). These tumours, in most cases, regress with glucocorticoid therapy and their histological differentiation from Leydig-cell tumors is quite difficult.
  
  
  OBJECTIVE
  The aim of this study was to differentiate the histological and clinical features of the TARTs from those of the Leydig-cell tumours.
  
  
  METHODS
  The authors report a case of bilateral Leydig-cell tumour associated with giant bilateral adrenal myelolipoma in a male with adrenogenital syndrome who was submitted to a bilateral orchiectomy.
  
  
  RESULTS
  Testicular neoplasia continue to grow despite adequate hormonal treatment and a bilateral orchiectomy was performed. The histopathological examination of the specimen ultimately confirmed the diagnosis of bilateral Leydig-cell tumour.
  
  
  CONCLUSIONS
  This case shows the importance of all the relevant examinations, blood chemistry analysis, and instrumental tests in the differential diagnosis of TARTs and other testicular tumours.
authors.affiliation: Department of Urology, Romolo Hospital, Rocca di Neto (Crotone) - Italy.
authors.forename: Vincenzo M
authors.initials: VM
authors.lastname: Altieri
authors.affiliation: Department of Endocrinology, University "Cattolica del Sacro Cuore", Rome - Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Altieri
authors.affiliation: Department of Urology, Humanitas Gavazzeni Hospital, Bergamo - Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castellucci
authors.affiliation: Department of Urology, Romolo Hospital, Rocca di Neto (Crotone) - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Alba
authors.affiliation: Department of Urology, Romolo Hospital, Rocca di Neto (Crotone) - Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bottone
authors.affiliation: Department of Urology, Romolo Hospital, Rocca di Neto (Crotone) - Italy.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Fragalà
authors.affiliation: Urology Division, University Federico II of Naples, Naples - Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.affiliation: Department of Urology, Romolo Hospital, Rocca di Neto (Crotone) - Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Greco
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D047808:Adrenogenital Syndrome / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000328:Adult; D006801:Humans; D007984:Leydig Cell Tumor / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008297:Male; D018209:Myelolipoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology* / Q000601:surgery