en Surgery Surgery case report case report <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><strong><em>Background</em></strong><em>:</em></span> Congenital adrenal hyperplasia (CAH) refers to group of congenital diseases resulting from impaired adrenal steroidogenesis, and its most common cause is 21-hydroxylase deficiency. Testicular adrenal residual tumor (TART) is one of the major complications of CAH, possibly resulting from ectopic remnants of intra-testicular adrenal tissue which is stimulated by excessive secretion of adrenocorticotropic hormone (ACTH). This tumor can be misdiagnosed as Leydig cell tumor (LCT) in these people.<br> <span style="color:#0000ff;"><strong><em>Case Presentation</em></strong><em>:</em></span> The patient we are presenting is a 20-year-old man with a history of precocious puberty and a height below 3% of the population who underwent radical left testicular orchiectomy with a complaint of bilateral testicular mass, which is reported LCT in the pathology report. In preoperative imaging examinations, bilateral adrenal hyperplasia is observed. In hormonal examinations, the patient is diagnosed with CAH and has been treated with corticosteroids for one year.<br> <span style="color:#0000ff;"><strong><em>Conclusion</em></strong><em>:</em></span> In patients who present with bilateral testicular mass, it is the best image by abdominopelvic CT scan before surgery to detect CAH.</span></span> Congenital Adrenal Hyperplasia, Adrenal rest Tumor, Leydig cell tumor 431 434 http://caspjim.com/browse.php?a_code=A-10-457-3&slc_lang=en&sid=1 Abazar Akbarzadeh Pasha Aapasha812@yahoo.com 100319475328460031208 100319475328460031208 No Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Hamid Shafi dr-hamidshafi@yahoo.com 100319475328460031209 100319475328460031209 No Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran Mohammad Teimorian emadmoudi@gmail.com 100319475328460031210 100319475328460031210 No Department of Urology, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran Ghasem Rostami emadmoudi@gmail.com 100319475328460031211 100319475328460031211 No Student Research Committee, Babol University of Medical Sciences, Babol, Iran Khatereh Nasirimehr emadmoudi@gmail.com 100319475328460031212 100319475328460031212 No Student Research Committee, Babol University of Medical Sciences, Babol, Iran Emadoddin Moudi emadmoudi@gmail.com 100319475328460031213 100319475328460031213 Yes Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran