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KMID : 0356620070220050365
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Journal of Korean Society of Endocrinology
2007 Volume.22 No. 5 p.365 ~ p.370
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A Case of Congenital Adrenal Hyperplasia Combined with a Testicular Adrenal Rest Tumor and Adrenal Incidentaloma
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Cho Gyu-Rang
Chueh Hee-Won
Kim Jung-Pyo
Jung Jin-A
Yoo Jae-Ho
Yoon Seong-Kuk
Hwang Kyu-Geun
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Abstract
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The fundamental defect among patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylse deficiency is the inability to synthesize cortisol and aldosterone adequately. Ineffective cortisol synthesis signals the hypothalamus and pituitary to increase the production of corticotropin releasing hormone and adrenocorticotropic hormone, respectively. Consequently, the adrenal glands become hyperplastic. It is well known that an adrenal adenoma can develop from hyperplastic tissue under increased corticotropin stimulation of the adrenal cortex in patients that are suffering with CAH. The etiologic mechanism of adrenal incidentaloma remains uncertain, but several hypotheses have been suggested. A testicular adrenal rest tumor has been reported to form in association with the excessive secretion of adrenal androgen by inadequate control after adolescence in CAH. We present a case of poorly controlled salt-losing CAH due to 21-hydroxylase deficiency combined with a testicular adrenal rest tumor and adrenal incidentaloma.
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KEYWORD
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Adrenal incidentaloma, Congenital adrenal hyperplasia, Testicular adrenal rest tumor
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