Congenital adrenal hyperplasia is an autosomal recessive disorder that impairs the production of two essential hormones, cortisol and aldosterone. This deficiency results in the overproduction of adrenocorticotropic hormone and overgrowth of the adrenal tissue. Specific forms of congenital adrenal hyperplasia can result in ambiguous genitalia, precocious puberty, short stature, and testicular adrenal rest tumors. Common sonographic findings of testicular rest tissue are multifocal hypoechoic lesions and a spokelike vascularity with multiple peripheral vessels. The sonographer needs to understand the correlation between congenital adrenal hyperplasia and testicular adrenal rest tumors so the testicular masses are not misdiagnosed.
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