Testicular adrenal rest tumors: current insights on prevalence, characteristics, origin and treatment.

Testicular adrenal rest tumors: current insights on prevalence, characteristics, origin and treatment. Endocr Rev. 2019 Mar 18;: Authors: Engels M, Span PN, van Herwaarden AE, Sweep FCGJ, Stikkelbroeck NMML, Claahsen-van der Grinten HL Abstract This review provides the reader with current insights on testicular adrenal rest tumors (TARTs), a complication in male patients with congenital adrenal hyperplasia (CAH).In recent studies, an overall TART prevalence of 40% (range 14-89%) in classic CAH-patients is found. Reported differences are mainly caused by the method of detection, and the selected patient population. Biochemically, histologically, and molecularly TARTs exhibit particular adrenal characteristics and were therefore thought to originate from aberrant adrenal cells. More recently TART has been found to also exhibit testicular characteristics. This has led to the hypothesis of pluripotent cells as the origin of TART. High concentrations of adrenocorticotropic hormone (ACTH) could cause hyperplasia of these pluripotent cells, as TART appears to be associated with poor hormonal control with concomitant elevated ACTH. Unfortunately, as yet there are no methods to prevent the development of TART, nor are there guidelines to treat patients with TART. Intensified glucocorticoid treatment could improve fertility status in some cases, although studies report contradicting results. TART can also lead to irreversible testicular damage...
Source: ENDOCR REV - Category: Endocrinology Authors: Tags: Endocr Rev Source Type: research