Congenital Adrenal Hyperplasia and Testicular Adrenal Rest Tumors Causing Infertility and Detected by 18F-FDG PET/CT

Testicular adrenal rest tumors (TARTs) are benign tumors often bilaterally located and are mostly diagnosed in adulthood. TARTs are seen in approximately 94% of patients with congenital adrenal hyperplasia (CAH). In this paper, we present a case of TARTs and CAH detected on 18F-fluorodeoxyglucose (FDG) PET/CT, as a rare case described in only one report in the literature. A 42-year-old patient presented to our outpatient clinic due to testicular masses. The patient had azoospermia, and his ultrasound images revealed bilateral solitary masses. In 18F-FDG PET/CT, high activity uptake was observed in both testicles, and bilateral adrenal hyperplasia was detected incidentally. When the patient's anamnesis was questioned, it was determined that pubarche occurred at the age of nine years, his body weight was 82 kg, and his height was 153 cm. Because of the hormonal evaluation, the patient was diagnosed with CAH and TARTs. In conclusion, 18F-FDG PET/CT may play a decisive role in the evaluation of infertile men with testicular masses.