Willard Scott,  Birkemeier Krista

Final Pr. ID: Poster #: CR-029

We present the case of a 14 year old Asian male with a history of poorly controlled congenital adrenal hyperplasia (CAH) and growing testicular adrenal rest tumors. While on high dose steroid therapy, the lesions decreased in size from 1.1 x 1.0 cm to 0.5 x 0.8 cm. However, they subsequently increased in size, measuring 2 to 3 cm in length when the patient was not compliant with the steroid regimen due to Cushingoid side effects. The masses were bilateral, symmetric, and located at the mediastinum testis, all findings consistent with testicular adrenal rest tumors as opposed to Leydig tumor. With growth, they coalesced to form undulating masses with hyperechoic and hypoechoic layers mimicking the cerebrum, an appearance more typically seen in the adrenal glands at initial diagnosis of CAH. Current practice guidelines in much of the developed world typically result in early diagnosis and advanced therapy, making testicular adrenal rest tumors of this size and appearance unique. Read More

Authors:  Willard Scott , Birkemeier Krista

Keywords:  congenital adrenal hyperplasia, CAH, testicular adrenal rest tumor, TART

Takahashi Marcelo,  Moreira Marcia,  Motta Giovanna,  Gual Fabiana,  Soares Juliana,  Davaus Taisa

Final Pr. ID: Poster #: EDU-039

Girls with congenital adrenal hyperplasia can present with a wide variety of urogenital malformations. Understanding these malformations and the anatomical relations between the pelvic structures is paramount for surgical planning. Imaging of these patients can be done by various methods such as genitography, magnetic resonance or endoscopy.
More recently some authors have begun to propose perineal ultrasound as an alternative for imaging of these patients for pre-operative planning.
In this educational poster we will use perineal ultrasound images and detailed illustrations to:
1) Review the spectrum of genital and lower urinary tract malformations related to congenital adrenal hyperplasia in girls.
2) Explain the transperineal ultrasound technique and normal anatomy.
3) Explain the transperineal ultrasound findings and utility in girls with congenital adrenal hyperplasia.

Contents:
Normal anatomy
Pathologic changes in congenital adrenal hyperplasia
Review of what is relevant to the referring surgeon.
Ultrasound technique
Ultrasound findings in normal patients
Ultrasound findings in congenital adrenal hyperplasia. Read More

Authors:  Takahashi Marcelo , Moreira Marcia , Motta Giovanna , Gual Fabiana , Soares Juliana , Davaus Taisa

Keywords:  congenital adrenal hyperplasia, ultrasound, perineum