Testicular tumours of adrenogenital syndrome

Testicular ‘tumour’ of adrenogenital syndrome usually presents as bilateral testicular masses in patients with congenital adrenal hyperplasia. A thorough clinical evaluation is usually sufficient for diagnosis. In most circumstances this condition is well managed by replacement hormone therapy and infrequently requires surgical intervention with consequent histopathology evaluation. Attempt at differentiation from the morphologically similar Leydig cell tumour on biopsy tissue has potential for misdiagnosis; however, this distinction is crucial due to significantly different clinical interventions and the related medico-legal implications of orchidectomy. Through the following case, we illustrate these diagnostic difficulties, provide a summary from review of recent literature to assist in correct interpretation, and also stress the impact of either diagnosis.