{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:27:23Z","timestamp":1765261643756,"version":"3.46.0"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Congenital adrenal hyperplasia (CAH) with testicular adrenal rest tumor (TART) is a sequela of 21\u2010hydroxylase deficiency in the background of adrenal hyperplasia in most cases. We report a case of a 10\u2010year\u2010old boy who presented with a 7\u2010day history of headache, vomiting, and abdominal pain, and had a blood pressure of 200\/140\u2009mmHg with a pulse rate of 84\u2009bpm, consistent with a hypertensive emergency. Clinical presentation showed precocious puberty with virilization. The patient appeared like an adult male with well\u2010developed secondary sexual characters and Tanner staging IV was assessed. Hard nodular testicular swellings were present on both sides. Regular laboratory investigations showed elevated urea and creatinine, suggesting renal failure. Imaging revealed bilateral enlarged adrenal glands and right testes were found to have a homogeneous hypoechoic mass. Ophthalmoscopy confirmed Grade IV retinopathy. After comprehensive evaluation and investigations, the final diagnosis was made to be CAH with right\u2010sided TART with hypertensive emergency with renal AKI and grade IV hypertensive retinopathy. He was treated initially with antihypertensives followed by hydrocortisone and NSAIDs. Early diagnosis is significant in CAH with TART to prevent infertility and irreversible testicular damage.<\/jats:p>","DOI":"10.1002\/ccr3.71498","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T04:24:32Z","timestamp":1763439872000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Silent Threat: A Complex Presentation of Testicular Adrenal Rest Tumors in a Male With Congenital Adrenal Hyperplasia"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9963-7481","authenticated-orcid":false,"given":"Shristi","family":"Gupta","sequence":"first","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9142-9661","authenticated-orcid":false,"given":"Aron","family":"Neupane","sequence":"additional","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1524-4491","authenticated-orcid":false,"given":"Kshitiz","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5070-8503","authenticated-orcid":false,"given":"Sagar","family":"Bhagat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nischal","family":"Timsina","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2103-8735","authenticated-orcid":false,"given":"Raja Babu","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2023.09.006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/624823"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.15009"},{"volume-title":"StatPearls [Internet]","year":"2023","author":"Momodu I. 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