The High Prevalence of Testicular Adrenal Rest Tumors in Adult Men With Congenital Adrenal Hyperplasia Is Correlated With ACTH Levels

Introduction: The aim of this study was to determine the prevalence of testicular-adrenal rest tumors (T-ARTs) in patients with congenital adrenal hyperplasia (CAH), and to evaluate the related ultrasound (US) features, hormonal profiles, and semen parameters. Therefore, we attempted to understand the potential impact of adrenocorticotropic hormone (ACTH) on the persistence or disappearance of T-ART. Methods: We conducted a longitudinal cohort study including patients with CAH who were undergoing treatment with cortisone and, when indicated fludrocortisone replacement therapy. We performed andrological examinations, US of the testis, hormone profiling, and semen analysis. Results: Of the 25 patients (mean±SD age, 32.2±7.5years), T-ARTs were detected by US in 14(56.0%) patients. The mean±SD diameter of the lesions was 13.2±6.8mm. Among 3(21.4%) patients, the lesions were observed in one testis, whereas both testes were affected in the remaining 11(78.6%) patients. The lesions were hypoechoic in 12(85.7%) patients and hyperechoic in 2 (14.3%). Plasma ACTH and 17-hydroxyprogesterone (17-OHP) levels were significantly higher in patients with T-ART than in patients without lesions (319.4±307.0pg/mL and 12.4±2.7ng/mL versus 33.5±10.7pg/mL and 8.2±1.8ng/mL, respectively; p
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research