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Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia

BACKGROUND: Testicular adrenal rest tumors (TARTs) are benign neoplasms affecting patients with congenital adrenal hyperplasia (CAH). The prevalence of TART in adult patients with CAH is not well known. Ultrasonography (US) is the main tool for diagnosing TART and the role of contrast-enhanced US (C...

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Autores principales: Corcioni, Beniamino, Renzulli, Matteo, Marasco, Giovanni, Baronio, Federico, Gambineri, Alessandra, Ricciardi, Domenico, Ortolano, Rita, Farina, Davide, Gaudiano, Caterina, Cassio, Alessandra, Pagotto, Uberto, Golfieri, Rita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947447/
https://www.ncbi.nlm.nih.gov/pubmed/33718059
http://dx.doi.org/10.21037/tau-20-998
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author Corcioni, Beniamino
Renzulli, Matteo
Marasco, Giovanni
Baronio, Federico
Gambineri, Alessandra
Ricciardi, Domenico
Ortolano, Rita
Farina, Davide
Gaudiano, Caterina
Cassio, Alessandra
Pagotto, Uberto
Golfieri, Rita
author_facet Corcioni, Beniamino
Renzulli, Matteo
Marasco, Giovanni
Baronio, Federico
Gambineri, Alessandra
Ricciardi, Domenico
Ortolano, Rita
Farina, Davide
Gaudiano, Caterina
Cassio, Alessandra
Pagotto, Uberto
Golfieri, Rita
author_sort Corcioni, Beniamino
collection PubMed
description BACKGROUND: Testicular adrenal rest tumors (TARTs) are benign neoplasms affecting patients with congenital adrenal hyperplasia (CAH). The prevalence of TART in adult patients with CAH is not well known. Ultrasonography (US) is the main tool for diagnosing TART and the role of contrast-enhanced US (CEUS) is never investigated. The aim of this study was to evaluate the TART prevalence in adults with CAH, by stratifying patients according to disease phenotype and assessing the diagnostic performance of US, color Doppler (CD) US and CEUS. METHODS: Male patients >16 years old with certain diagnosis of CAH who underwent US for TARTs, between December 2015 and September 2019 were prospectively enrolled. The control group included patients without CAH affected by testicular lesions at US other than TARTs. RESULTS: TARTs were identified in 16 of 52 patients (31%), of whom 15 (93.8%) displayed the salt-wasting (SW) form (P<0.001). The prevalence of TARTs in patients with the SW form was 54%. One patient with the non-classic (NC) form (6%) showed TART (likely the first documented case). The mean age of patients upon detection of TARTs was significantly younger compared with the control group (P<0.001); moreover, TARTs were bilateral in 15/16 patients (93.8%; P<0.001) and the largest lesion was more frequent in the medium third of testis in the TART group (87.5%), statistically different from the control group (P=0.013). CONCLUSIONS: TARTs almost exclusively affected patients with the SW form of CAH. Age at diagnosis and bilateralism are useful factors for achieving a correct diagnosis of TARTs in CAH adult patients.
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spelling pubmed-79474472021-03-12 Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia Corcioni, Beniamino Renzulli, Matteo Marasco, Giovanni Baronio, Federico Gambineri, Alessandra Ricciardi, Domenico Ortolano, Rita Farina, Davide Gaudiano, Caterina Cassio, Alessandra Pagotto, Uberto Golfieri, Rita Transl Androl Urol Original Article BACKGROUND: Testicular adrenal rest tumors (TARTs) are benign neoplasms affecting patients with congenital adrenal hyperplasia (CAH). The prevalence of TART in adult patients with CAH is not well known. Ultrasonography (US) is the main tool for diagnosing TART and the role of contrast-enhanced US (CEUS) is never investigated. The aim of this study was to evaluate the TART prevalence in adults with CAH, by stratifying patients according to disease phenotype and assessing the diagnostic performance of US, color Doppler (CD) US and CEUS. METHODS: Male patients >16 years old with certain diagnosis of CAH who underwent US for TARTs, between December 2015 and September 2019 were prospectively enrolled. The control group included patients without CAH affected by testicular lesions at US other than TARTs. RESULTS: TARTs were identified in 16 of 52 patients (31%), of whom 15 (93.8%) displayed the salt-wasting (SW) form (P<0.001). The prevalence of TARTs in patients with the SW form was 54%. One patient with the non-classic (NC) form (6%) showed TART (likely the first documented case). The mean age of patients upon detection of TARTs was significantly younger compared with the control group (P<0.001); moreover, TARTs were bilateral in 15/16 patients (93.8%; P<0.001) and the largest lesion was more frequent in the medium third of testis in the TART group (87.5%), statistically different from the control group (P=0.013). CONCLUSIONS: TARTs almost exclusively affected patients with the SW form of CAH. Age at diagnosis and bilateralism are useful factors for achieving a correct diagnosis of TARTs in CAH adult patients. AME Publishing Company 2021-02 /pmc/articles/PMC7947447/ /pubmed/33718059 http://dx.doi.org/10.21037/tau-20-998 Text en 2021 Translational Andrology and Urology. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Corcioni, Beniamino
Renzulli, Matteo
Marasco, Giovanni
Baronio, Federico
Gambineri, Alessandra
Ricciardi, Domenico
Ortolano, Rita
Farina, Davide
Gaudiano, Caterina
Cassio, Alessandra
Pagotto, Uberto
Golfieri, Rita
Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
title Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
title_full Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
title_fullStr Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
title_full_unstemmed Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
title_short Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
title_sort prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947447/
https://www.ncbi.nlm.nih.gov/pubmed/33718059
http://dx.doi.org/10.21037/tau-20-998
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