Table 1 Proposed classification of testicular adrenal rests.
From: Testicular Adrenal Rest Tumours in Congenital Adrenal Hyperplasia
| Â | Histological description | Reversibility | Treatment options |
|---|---|---|---|
Stage 1 | Presence of adrenal rests within the rete testis—not detectable | +++ | — |
Stage 2 | Hypertrophy and hyperplasia of adrenal rest cells due to growth stimulating factors (e.g., ACTH, AII) | +++ | Optimizing glucocorticoids |
Stage 3 | Further growth of the adrenal rest cells with (reversible) compression of the rete testis | ++ | Optimizing glucocorticoids Surgery? |
Stage 4 | Induction of fibrosis and focal lymphocytic infiltrates | −/+ | Surgery? |
Stage 5 | Irreversible damage of testicular parenchyma. | − | — |
| Â | Parts of the tumour are replaced by adipose tissue | Â | Â |