Fernandes Virginia Oliveira, Barros Antonio Iran Souza, Quidute Ana Rosa Pinto, Montenegro Ana Paula Dias Rangel, Fontenele Eveline Gadelha Pereira, Sales Ana Paula Abreu Martins, Montenegro Renan Magalhães, Ferreira Francisco Valdeci de Almeida, Montenegro Renan Magalhães
Serviço de Endocrinologia e Diabetes, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
Arq Bras Endocrinol Metabol. 2009 Nov;53(8):1052-8. doi: 10.1590/s0004-27302009000800022.
Testicular tumors are a rare condition associated with congenital adrenal hyperplasia (CAH), originated from intratesticular adrenal rest tumors, and they are rarely associated with malignant tumors. Their histological differentiation from Leydig-cell tumors is quite difficult, which would lead to inappropriate orchiectomies. Thus the objective of this report was to present this diagnostic dilemma.
Reported the case of 16-yr-old boy with previous diagnosis of CAH with bilateral testicular enlargement who was recommended to be submitted to a bilateral orchiectomy.
Considering this findings, it was decided to treat conventionally with prednisone with significant reduction of testicular volume, and normalization of androgens levels.
This case shows the importance of intratesticular adrenal rest tumors in the differential diagnosis of testicular tumors. Cautious approach during investigation and treatment are recommended to avoid inappropriate orchiectomies.
睾丸肿瘤是一种与先天性肾上腺皮质增生症（CAH）相关的罕见病症，起源于睾丸内肾上腺残余肿瘤，且很少与恶性肿瘤相关。它们与莱迪希细胞瘤在组织学上的鉴别相当困难，这可能导致不恰当的睾丸切除术。因此，本报告的目的是呈现这一诊断难题。
报告一名16岁男孩的病例，该男孩先前被诊断为CAH且双侧睾丸肿大，曾被建议接受双侧睾丸切除术。
考虑到这些发现，决定采用泼尼松进行常规治疗，睾丸体积显著减小，雄激素水平恢复正常。
本病例显示了睾丸内肾上腺残余肿瘤在睾丸肿瘤鉴别诊断中的重要性。建议在检查和治疗过程中采取谨慎的方法，以避免不恰当的睾丸切除术。
