Table 1.

Proposed classification of testicular adrenal rests.

	Histological description	Reversibility	Treatment options
Stage 1	Presence of adrenal rests within the rete testis—not detectable	+++	—
Stage 2	Hypertrophy and hyperplasia of adrenal rest cells due to growth stimulating factors (e.g., ACTH, AII)	+++	Optimizing glucocorticoids
Stage 3	Further growth of the adrenal rest cells with (reversible) compression of the rete testis	++	Optimizing glucocorticoids Surgery?
Stage 4	Induction of fibrosis and focal lymphocytic infiltrates	−/+	Surgery?
Stage 5	Irreversible damage of testicular parenchyma.	−	—
	Parts of the tumour are replaced by adipose tissue