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.
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.
Authors: Mimi S Kim; Christina M Koppin; Pankhuri Mohan; Fariba Goodarzian; Heather M Ross; Mitchell E Geffner; Roger De Filippo; Paul Kokorowski Journal: Horm Res Paediatr Date: 2019-11-20 Impact factor: 2.852
Authors: Adina F Turcu; Aya T Nanba; Robert Chomic; Sunil K Upadhyay; Thomas J Giordano; James J Shields; Deborah P Merke; William E Rainey; Richard J Auchus Journal: Eur J Endocrinol Date: 2016-02-10 Impact factor: 6.664
Authors: Phyllis W Speiser; Ricardo Azziz; Laurence S Baskin; Lucia Ghizzoni; Terry W Hensle; Deborah P Merke; Heino F L Meyer-Bahlburg; Walter L Miller; Victor M Montori; Sharon E Oberfield; Martin Ritzen; Perrin C White Journal: J Clin Endocrinol Metab Date: 2010-09 Impact factor: 5.958