Sonographic appearance of testicular adrenal rest tissue in congenital adrenal hyperplasia

Benign intratesticular lesions are rare, but recognition is important to avoid unnecessary surgical intervention. Testicular adrenal rest tissue, a subtype of the benign intratesticular lesion, occurs in up to 29% of patients with congenital adrenal hyperplasia (CAH). The presence of adrenal rest tissue in testes usually appears as a testicular mass and is often mistaken for a malignant intratesticular lesion, thereby resulting in radical orchiectomy. It is important to recognize this association of adrenal rest tissue in patients with CAH to avoid unnecessary orchiectomies. We present the sonographic findings of CAH with testicular adrenal rest tissue in a patient with a testicular mass.