{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:24:25Z","timestamp":1787775865341,"version":"build-2784847793"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Testicular Adrenal Rest Tumors (TART) is one of the complications in male Congenital Adrenal Hyperplasia (CAH) patients that need early detection using scrotal ultrasonography. This systematic review aims to provide an up-to-date summary of the current understanding of scrotal ultrasonography features of testicular adrenal rest tumors in male congenital adrenal hyperplasia patients to help medical professionals diagnose TART in male CAH patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review was conducted using the PRISMA methodology. The authors searched for studies through PubMed from the last ten years until August 2023. Male CAH patients diagnosed by clinical and hormonal examination or genetic analysis with at least one of the features of TART in scrotal ultrasonography were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      This systematic review involved fourteen studies that were classified into retrospective cohort study (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 5), cross-sectional study (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4), and prospective cohort study (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 5). The total number of participants from fourteen studies was 597 patients, and 186 patients were found to have TART (31.16%). Studies showed that bilateral lesions (78.49%), lesions located near the mediastinum testes (89.61%), hypoechoic (81.94%), clear border (76.74%), round to oval lesions (44.44%, 55.56%, respectively), and hypervascular (69.39%) in color doppler ultrasound were found in male CAH patients with TART.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Scrotal ultrasonography features of TART in male CAH patients were primarily bilateral, located near the mediastinum testes, hypoechoic, clear border, round to oval shape, and hypervascular in color Doppler ultrasound.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_19_24","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T12:00:55Z","timestamp":1745928055000},"page":"133-141","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Scrotal Ultrasonography Features of Testicular Adrenal Rest Tumors in Male Congenital Adrenal Hyperplasia Patients: A Systematic Review"],"prefix":"10.4103","volume":"29","author":[{"given":"Epifani A.","family":"Chandra","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Diponegoro University, Semarang, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agustini","family":"Utari","sequence":"additional","affiliation":[{"name":"Center for Biomedical Research (CEBIOR), Faculty of Medicine, Diponegoro University, Semarang, Indonesia"},{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Diponegoro National Hospital, Diponegoro University, Semarang, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"R1-20250429","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1210\/endrev\/bnab016","article-title":"Congenital adrenal hyperplasia\u2014current insights in pathophysiology, diagnostics, and management","volume":"43","author":"Claahsen-van","year":"2022","journal-title":"Endocr Rev"},{"key":"R3-20250429","doi-asserted-by":"crossref","first-page":"98","DOI":"10.23886\/ejki.8.11611.","article-title":"Preliminary study of newborn screening for congenital hypothyroidism and congenital adrenal hyperplasia in Indonesia","volume":"8","author":"Pulungan","year":"2020","journal-title":"eJKI"},{"key":"R4-20250429","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000365570","article-title":"Increased prevalence of testicular adrenal rest tumours during adolescence in congenital adrenal hyperplasia","volume":"82","author":"Claahsen-van","year":"2014","journal-title":"Horm Res Paediatr"},{"key":"R5-20250429","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1210\/endo-26-3-385","article-title":"Macrogenitosomia precox associated with hyperplasia of the androgenic tissue of the adrenal and death from corticoadrenal insufficiency case report","volume":"26","author":"Wilkins","year":"1940","journal-title":"Endocrinol"},{"key":"R6-20250429","doi-asserted-by":"crossref","first-page":"383","DOI":"10.7863\/jum.2012.31.3.383","article-title":"Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia: Prevalence and sonographic, hormonal, and seminal characteristics","volume":"31","author":"Delfino","year":"2012","journal-title":"J Ultrasound Med"},{"key":"R7-20250429","doi-asserted-by":"crossref","first-page":"5721","DOI":"10.1210\/jcem.86.12.8090","article-title":"High prevalence of testicular adrenal rest tumors, impaired spermatogenesis, and Leydig cell failure in adolescent and adult males with congenital adrenal hyperplasia","volume":"86","author":"Stikkelbroeck","year":"2001","journal-title":"J Clin Endocrinol metabol"},{"key":"R8-20250429","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1210\/jc.2014-4124","article-title":"Clinical outcome, hormonal status, gonadotrope axis, and testicular function in 219 adult men born with classic 21-hydroxylase deficiency. A French national survey","volume":"100","author":"Bouvattier","year":"2015","journal-title":"J Clin Endocrinol Metabol"},{"key":"R9-20250429","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1210\/jc.2006-1311","article-title":"Testicular adrenal rest tumors in adult males with congenital adrenal hyperplasia: Evaluation of pituitary-gonadal function before and after successful testis-sparing surgery in eight patients","volume":"92","author":"Claahsen-van","year":"2007","journal-title":"J Clin Endocrinol Metabol"},{"key":"R10-20250429","doi-asserted-by":"crossref","first-page":"335","DOI":"10.3389\/fendo.2019.00335","article-title":"The high prevalence of testicular adrenal rest tumors in adult men with congenital adrenal hyperplasia is correlated with ACTH levels","volume":"10","author":"Mazzilli","year":"2019","journal-title":"Front Endocrinol"},{"key":"R11-20250429","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.juro.2016.09.072","article-title":"Testicular adrenal rest tumors in boys and young adults with congenital adrenal hyperplasia","volume":"197","author":"Kim","year":"2017","journal-title":"J Urol"},{"key":"R12-20250429","doi-asserted-by":"crossref","first-page":"986","DOI":"10.15537\/smj.2021.42.9.20210257","article-title":"Testicular adrenal rest tumors in children with congenital adrenal hyperplasia","volume":"42","author":"Al-Ghamdi","year":"2021","journal-title":"Saudi Med J"},{"key":"R13-20250429","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/and.12416","article-title":"Testicular adrenal rest tumours in young adult males with congenital adrenal hyperplasia: Prevalence and impact on testicular function","volume":"48","author":"Chihaoui","year":"2016","journal-title":"Andrologia"},{"key":"R14-20250429","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/s12098-018-02848-6","article-title":"Growth pattern and clinical profile of Indian children with classical 21-hydroxylase deficiency congenital adrenal hyperplasia on treatment","volume":"86","author":"Meena","year":"2019","journal-title":"Indian J Pediatr"},{"key":"R15-20250429","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1530\/EJE-20-1154","article-title":"Semen quality and testicular adrenal rest tumour development in 46, XY congenital adrenal hyperplasia: The importance of optimal hormonal replacement","volume":"184","author":"Rohayem","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"R16-20250429","doi-asserted-by":"crossref","first-page":"583","DOI":"10.12659\/PJR.901986","article-title":"Sonography and magnetic resonance imaging characteristics of testicular adrenal rest tumors","volume":"82","author":"Y\u0131lmaz","year":"2017","journal-title":"Pol J Radiol"},{"key":"R17-20250429","doi-asserted-by":"crossref","first-page":"n160","DOI":"10.1136\/bmj.n160","article-title":"PRISMA 2020 explanation and elaboration: Updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R18-20250429","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R19-20250429","doi-asserted-by":"crossref","first-page":"562","DOI":"10.21037\/tau-20-998","article-title":"Prevalence and ultrasound patterns of testicular adrenal rest tumors in adults with congenital adrenal hyperplasia","volume":"10","author":"Corcioni","year":"2021","journal-title":"Transl Androl Urol"},{"key":"R20-20250429","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/cen.12033","article-title":"Prevalence and long-term follow-up outcomes of testicular adrenal rest tumours in children and adolescent males with congenital adrenal hyperplasia","volume":"78","author":"Aycan","year":"2013","journal-title":"Clin Endocrinol"},{"key":"R21-20250429","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s00431-017-3008-7","article-title":"Testicular adrenal rest tumors in congenital adrenal hyperplasia\u2014cross-sectional study of 51 Croatian male patients","volume":"176","author":"Dumic","year":"2017","journal-title":"Eur J Pediatr"},{"key":"R22-20250429","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1159\/000492082","article-title":"Prevalence of testicular adrenal rest tumor and factors associated with its development in congenital adrenal hyperplasia","volume":"90","author":"Mendes-dos-Santos","year":"2018","journal-title":"Horm Res Paediatr"},{"key":"R23-20250429","doi-asserted-by":"crossref","first-page":"155","DOI":"10.6065\/apem.2015.20.3.155","article-title":"Clinical manifestations of testicular adrenal rest tumor in males with congenital adrenal hyperplasia","volume":"20","author":"Yu","year":"2015","journal-title":"Ann Pediatr Endocrinol Metab"},{"key":"R24-20250429","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13023-019-1231-1","article-title":"Sonographic features of the testicular adrenal rests tumors in patients with congenital adrenal hyperplasia: A single-center experience and literature review","volume":"14","author":"Ma","year":"2019","journal-title":"Orphanet J Rare Dis"},{"key":"R25-20250429","first-page":"209","article-title":"Testicular adrenal rest tumours in congenital adrenal hyperplasia","volume":"23","author":"Claahsen-Van","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"R26-20250429","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1210\/er.2018-00258","article-title":"Testicular adrenal rest tumors: Current insights on prevalence, characteristics, origin, and treatment","volume":"40","author":"Engels","year":"2019","journal-title":"Endocr Rev"}],"container-title":["Indian Journal of Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_19_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:44:04Z","timestamp":1787773444000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_19_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijem.ijem_19_24","relation":{},"ISSN":["2230-8210","2230-9500"],"issn-type":[{"value":"2230-8210","type":"print"},{"value":"2230-9500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-01-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}