Testicular Adrenal Rest Tumor in Congenital Adrenal Hyperplasia Patients Attending Assuit University Children Hospital

NCT ID: NCT06564220

Last Updated: 2024-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-10-31

Study Completion Date

2025-12-31

Brief Summary

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assessment of the risk factors contributing for TART development in a male child with congenital adrenal hyperplasia.

Detailed Description

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Congenital adrenal hyperplasia (CAH) is one of the most frequent endocrine disorders. It is characterized by deficient activity of one of the enzymes necessary for adrenal Cortisol synthesis. Autosomal recessive inheritance of deficient 21-hydroxylase (21 OH) activity accounts for more than 90% of cases. \[1\]

One of the most important and frequently detected complications in males with congenital adrenal hyperplasia (CAH) is the development of testicular adrenal rest tumours (TARTs). . \[2\],\[3\]

Testicular adrenal rest tumor is a benign tumor originating from adrenal cells within the testicles; the adrenal cells migrate at 8 weeks of gestation from the urogenital ridge along with the gonadal cells to the testicle. The exact mechanism underlying tumor growth and development is still not well understood . \[4\],\[5\]

The correct diagnosis of TART is important for differential diagnosis with malignant testis tumors, which need orchiectomy, as opposed to TART, usually treated exclusively with exogenous steroids. \[6\].

Although TARTs are always benign, their location in the rete testis could obstructs the seminiferous tubules and causes gonadal dysfunction and infertility. Therefore, it is important to detect and treat TARTs at an early stage, especially in adolescents or young adults. \[5\],\[7\]

testicular ultrasound should be done in order to evaluate the presence of these lesions, its size, location, and characteristics. \[9\]

TARTs in children have mostly been presented as case reports in the literature, and only a limited number of studies have described the prevalence of TARTs in large populations of children . \[2\],\[8\]

As not all male CAH patients are affected by this complication, attempts have been made to identify the risk factors for the development of TARTs . \[7\]

Conditions

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Testicular Adrenal Rest Tumor Congenital Adrenal Hyperplasia

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* All male patients diagnosed as congenital adrenal hyperplasia based on clinical manifestations and laboratory investigations from age of 4 years to age of 18 years.

Exclusion Criteria

* Patients with other adrenal insufficiency cause and Congenital adrenal hyperplasia that progressed to true precocious puberty
Minimum Eligible Age

4 Years

Maximum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Amira Refaat Zain El-Abidin Zahran

71515,Assuit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Shimaa K Mohamed

Role: STUDY_DIRECTOR

Lecturer of pediatric, faculty of medicine Assiut University

Central Contacts

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Amira R Zain el Abidin

Role: CONTACT

01020456650

Hanaa A Mohamed, Professor

Role: CONTACT

01064747613

References

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Grunieiro-Papendieck L, Chiesa A, Mendez V, Prieto L. Neonatal screening for congenital adrenal hyperplasia: experience and results in Argentina. J Pediatr Endocrinol Metab. 2008 Jan;21(1):73-8. doi: 10.1515/jpem.2008.21.1.73.

Reference Type BACKGROUND
PMID: 18404975 (View on PubMed)

Aycan Z, Bas VN, Cetinkaya S, Yilmaz Agladioglu S, Tiryaki T. Prevalence and long-term follow-up outcomes of testicular adrenal rest tumours in children and adolescent males with congenital adrenal hyperplasia. Clin Endocrinol (Oxf). 2013 May;78(5):667-72. doi: 10.1111/cen.12033.

Reference Type BACKGROUND
PMID: 23057653 (View on PubMed)

Engels M, Span PN, van Herwaarden AE, Sweep FCGJ, Stikkelbroeck NMML, Claahsen-van der Grinten HL. Testicular Adrenal Rest Tumors: Current Insights on Prevalence, Characteristics, Origin, and Treatment. Endocr Rev. 2019 Aug 1;40(4):973-987. doi: 10.1210/er.2018-00258.

Reference Type BACKGROUND
PMID: 30882882 (View on PubMed)

Al-Ghamdi WM, Shazly MA, Al-Agha AE. Testicular adrenal rest tumors in children with congenital adrenal hyperplasia. Saudi Med J. 2021 Sep;42(9):986-993. doi: 10.15537/smj.2021.42.9.20210257.

Reference Type BACKGROUND
PMID: 34470837 (View on PubMed)

Chaudhari M, Johnson EK, DaJusta D, Nahata L. Testicular adrenal rest tumor screening and fertility counseling among males with congenital adrenal hyperplasia. J Pediatr Urol. 2018 Apr;14(2):155.e1-155.e6. doi: 10.1016/j.jpurol.2017.11.011. Epub 2017 Dec 21.

Reference Type BACKGROUND
PMID: 29330018 (View on PubMed)

Eyer de Jesus L, Paz de Oliveira AP, Porto LC, Dekermacher S. Testicular adrenal rest tumors - Epidemiology, diagnosis and treatment. J Pediatr Urol. 2024 Feb;20(1):77-87. doi: 10.1016/j.jpurol.2023.10.005. Epub 2023 Oct 7.

Reference Type BACKGROUND
PMID: 37845103 (View on PubMed)

Rivera-Hernandez A, Jimenez-Osorio M, Rodriguez-Mencias JP, Escamilla-Castaneda KM, Madrigal-Gonzalez MM, Zurita-Cruz J. Risk factors for testicular adrenal rest tumors in pediatric patients with congenital adrenal hyperplasia. J Pediatr Urol. 2023 Aug;19(4):398.e1-398.e7. doi: 10.1016/j.jpurol.2023.03.028. Epub 2023 Mar 24.

Reference Type BACKGROUND
PMID: 37029011 (View on PubMed)

Stikkelbroeck NM, Otten BJ, Pasic A, Jager GJ, Sweep CG, Noordam K, Hermus AR. High prevalence of testicular adrenal rest tumors, impaired spermatogenesis, and Leydig cell failure in adolescent and adult males with congenital adrenal hyperplasia. J Clin Endocrinol Metab. 2001 Dec;86(12):5721-8. doi: 10.1210/jcem.86.12.8090.

Reference Type BACKGROUND
PMID: 11739428 (View on PubMed)

Tresoldi AS, Betella N, Hasenmajer V, Pozza C, Vena W, Fiamengo B, Negri L, Cappa M, Lania AGA, Lenzi A, Isidori AM, Pizzocaro A. Bilateral testicular masses and adrenal insufficiency: is congenital adrenal hyperplasia the only possible diagnosis? First two cases of TARTS described in Addison-only X-linked adrenoleukodystrophy and a brief review of literature. J Endocrinol Invest. 2021 Mar;44(3):391-402. doi: 10.1007/s40618-020-01362-x. Epub 2020 Jul 20.

Reference Type BACKGROUND
PMID: 32691371 (View on PubMed)

Other Identifiers

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Testicular adrenal rest tumor

Identifier Type: -

Identifier Source: org_study_id

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