Testicular adrenal rest tumors (TARTs) as a male infertility factor. Case report

Since testes and adrenal cortex derive from the same urogenital ridge, adrenal tissue with descending gonads may migrate in early embryonic period. Although most often ectopic tissue undergoes atrophy in some cases, when adrenocorticotrophic (ACTH) overstimulation occurs, the adrenal remnants in the...

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Bibliographic Details
Published in:Ginekologia polska 2012-09, Vol.83 (9), p.700-702
Main Authors: Niedziela, Marek, Joanna, Talarczyk, Piotr, JedrzejczaK
Format: Article
Language:English
Subjects:
Adrenal Hyperplasia, Congenital - complications
Adrenal Hyperplasia, Congenital - diagnostic imaging
Adrenal Rest Tumor - complications
Adrenal Rest Tumor - diagnostic imaging
Azoospermia - diagnosis
Azoospermia - etiology
Case reports
Humans
Infertility
Male
Poland
Testes
Testicular Neoplasms - complications
Testicular Neoplasms - diagnostic imaging
Testis - diagnostic imaging
Ultrasonography
Young Adult
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Summary:Since testes and adrenal cortex derive from the same urogenital ridge, adrenal tissue with descending gonads may migrate in early embryonic period. Although most often ectopic tissue undergoes atrophy in some cases, when adrenocorticotrophic (ACTH) overstimulation occurs, the adrenal remnants in the testes may become hypertrophic and form testicular adrenal rest tumors (TARTs). The growth of TARTs in the testes leads to obstruction of the seminiferous tubules which can mechanically impair the function of the gonads and cause irreversible azoospermia. We describe a patient suffering since neonatal period from congenital adrenal hyperplasia (CAH), disorder with defected pathway of cortisol production, which leads to increased ACTH production and to overstimulation of adrenal cortex. He had very poor disease control and therefore in late puberty he was diagnosed with TARTs. At the age of 19.5 he was diagnosed with azoospermia, most likely caused by TARTs. It is the first evidence of TARTs in Polish literature. Although not many cases have been published so far the incidence of TARTs seems to be highly underdiagnosed, so it seems reasonable to consider the disease in differential diagnosis of male infertility.
ISSN:0017-0011
2543-6767