Frequency of testicular adrenal rest tumor in male congenital adrenal hyperplasia.

Abstract

Objective: To determine the frequency of testicular adrenal rest tumour (TART) in male children suffering from congenital adrenal hyperplasia (CAH). Study Design: Cross-sectional study. Setting: Department of Endocrinology, National Institute of Child Health (NICH), Karachi, Pakistan. Period: January 2024 to August 2024. Methods: Male children aged 2 to 16 years, and diagnosed cases of CAH were analyzed. Among children fulfilling the eligibility criteria, demographic and clinical characteristics were noted. TART was diagnosed on clinical evaluation, ultrasound, or biochemical analysis of hormones. Results: In a total of 121 children, the mean age was 7.34±3.69 years. The mean duration of CAH was 6.73±3.49 years, respectively. The most common presenting complaints were vomiting, dehydration, diarrhea, and abdominal pain, reported in 75 (62.0%), 41 (33.9%), 35 (28.9%), and 31 (25.6%), respectively, TART was identified in 33 (27.3%) children with CAH. The frequency of TART was significantly associated with relatively higher age (p<0.001), weight (p<0.001), and height (p<0.001). The duration of CAH was significantly higher among children with TART (p<0.001). It was noted that 17-OHP (p<0.001), and ACTH (p<0.001) were significantly higher among children with TART. Comparison of the frequency of TART revealed significant association with palpitation (p<0.001), and pubic hairs (p=0.003). Vomiting was found to have significant association with children without TART (p=0.035). Conclusion: The prevalence of TART in male children with CAH was high, with significant associations between TART and older age, prolonged CAH duration, higher weight, height, and elevated levels of 17-OHP and ACTH.