Sonographic Spectrum of Testicular Adrenal Rest Tumors

Testicular adrenal rest tumors (TARTs) are benign testicular masses but can lead to infertility without medical attention. It is important to identify TARTs in childhood, as early diagnosis has been shown to have good success in preserving fertility. It is also important to differentiate TARTs from other testicular masses to avoid unnecessary orchiectomy. Ultrasound is the preferred imaging modality for the evaluation of TARTs; however, sonographic differentiation from testicular neoplasms can sometimes be very difficult. In this article, we review the spectrum of sonographic features of TARTs and propose a decision tree that relies on these features, with the goal of increasing clinician’s confidence in diagnosing TARTs.