Prevalence of testicular adrenal rest tissue in neonates.

Abstract

BACKGROUND: Infertility is a serious complication among male congenital adrenal hyperplasia (CAH) patients which is often caused by testicular adrenal rest tumors (TART). TART are already present in childhood and early infancy in CAH patients. The incidence of TART in neonates without CAH has not yet been described in detail before. OBJECTIVE: To study the prevalence of testicular adrenal rests in non-CAH neonates. DESIGN: Descriptive study. SETTING: Radboud University Nijmegen Medical Centre, The Netherlands. PATIENTS AND METHODS: 115 testis samples of 89 male infants without CAH who died within the neonatal period were histologically examined. MAIN OUTCOME MEASURES: Prevalence of adrenal rest tissue in the neonatal testes. RESULTS: Adrenal rests were found in 4 samples (3.5%). These adrenal nodules were all located within the epididymis; only in 1 sample a nodule was found close to the rete testis but still within the caput of the epididymis. No nodules were found within the testes. Of the 4 children with adrenal rests, 3 had urological malformations. CONCLUSION: The incidence of testicular adrenal rests in non-CAH neonates is low. Further studies are necessary to study the incidence of TART in CAH infants and detect typical risk factors in this patient group.