Abstract | OBJECTIVE: METHODS: Eighteen patients affected by CAH, aged 21 to 41 years, were studied. These were all patients referred to our endocrinology unit for the first time to undergo a clinical evaluation. All of the patients were taking long-term cortisone acetate and fludrocortisone replacement therapy. The study included (1) a physical examination, (2) testis sonography, (3) a hormonal profile, (4) semen analysis. RESULTS: Sonography showed testicular adrenal rest tumors in 11 patients (61.1%); of these, 9 cases (50.0%) were bilateral, and 2 (11.1%) were unilateral. The diameter ranged from 4 to 38 mm. In 9 patients, the lesions were hypoechoic, whereas in 2, they were hyperechoic. High plasma ACTH levels were detected in all of the patients with tumors despite long-term therapy. Semen analysis found 2 cases of azoospermia and 6 cases of oligoasthenoteratozoospermia; the 3 remaining patients were normospermic. The preliminary longitudinal study has shown 3 patients with a disappearance or reduction of the tumors after 6 months of modified treatment. CONCLUSIONS: This study confirms the high prevalence of testicular adrenal rest tumors in patients with CAH and the major role played in its pathogenesis by high plasma ACTH levels.
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Authors | Michele Delfino, Jlenia Elia, Norina Imbrogno, Nicola Argese, Rossella Mazzilli, Vincenzo Toscano, Fernando Mazzilli |
Journal | Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
(J Ultrasound Med)
Vol. 31
Issue 3
Pg. 383-8
(Mar 2012)
ISSN: 1550-9613 [Electronic] England |
PMID | 22368128
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers, Tumor
- Adrenocorticotropic Hormone
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Topics |
- Adrenal Hyperplasia, Congenital
(complications)
- Adrenal Rest Tumor
(diagnostic imaging, epidemiology, etiology)
- Adrenocorticotropic Hormone
(blood)
- Adult
- Biomarkers, Tumor
(blood)
- Humans
- Longitudinal Studies
- Male
- Prevalence
- Semen Analysis
- Testicular Neoplasms
(diagnostic imaging, epidemiology, etiology)
- Ultrasonography, Doppler, Color
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