Intratesticular masses associated with abnormally functioning adrenal glands

✍ Scribed by Thomas H. Shawker; John L. Doppman; Peter L. Choyke; Irwin M. Feuerstein; Lynnette K. Nieman

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 845 KB
• Volume: 20
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870200110

✦ Synopsis

The association between abnormally functioning adrenal glands and certain specific focal testicular lesions is not widely appreciated. Although rare, this relationship must be recognized so that the proper clinical management can be initiated. In the past, patients have been misdiagnosed, had their treatment delayed, or have had inappropriate treatment including unnecessary orchiectomy. The clinical course and imaging findings of 3 patients who had both bilateral focal testicular lesions and adrenal gland abnormalities will be presented in order to show the clinical, radiologic, and pathologic aspects of this relationship.

CASES

Case 1

In 1961 at birth, this male patient was diagnosed as having 21-hydroxylase deficiency with salt wasting. He did well on steroid therapy until 1987 when a left testicular mass was felt. The patient underwent a left radical orchiectomy. Pathological diagnosis was intratesticular Leydig cell tumor.

During a subsequent examination, the patient was noted to have a small, 1.5 cm x 0.5 cm painless nodule on the upper posterior portion of the right testicle. An ultrasound examination showed the palpable nodule to be an ill-defined, hypoechoic intratesticular solid mass measuring From the