Gynaecomastia and Occult Leydig Cell Tumour of the Testis

Abstract

Two patients with Leydig cell tumours of the testis are described. Both presented with gynaecomastia, but on initial examination had apparently normal testes. The causative tumour did not become obvious for some months, despite being carefully sought. Review of the literature suggests that gynaecomastia preceding a readily palpable tumour is a recognised problem. The detection and management of Leydig cell tumours of the testis are discussed.

Male gynecomastia and risk for malignant tumours – a cohort study

“…This was also evident in our material (table 1). It has previously been shown in case series that testicular cancer may sometimes prior to diagnosis induce gynecomastia due to pathologic HCG secretion [5-7]. In this prospective series two patients developed testicular seminomas and one patient a testicular teratoma following the diagnosis of gynecomastia years earlier.…”

Leydig cell tumor of testis- a rare case report

“…6,7 They are mostly benign in children, whereas in adults they are malignant in 10% of cases. 2,3 LCTs are hormonally active and considered as one of the steroid-secreting tumors. They produce androgens, mainly testosterone, but can produce estrogen by either direct production of estradiol or peripheral aromatization of testosterone.…”

“…In young patients, they are mostly benign and in adults it can be malignant in about 10 % cases. 2,3 The incidence of Leydig cell tumors is gradually increasing every year which might be attributed to increased use of radiological techniques and subsequent early detection of tumors that have not been found in historical series.…”

Clinically Occult Leydig Cell Tumor in a Cryptorchid Man

“…The excess of androgens in children often causes gynecomastia and mastodynia while in adults these clinical signs in 10% are associated with loss of libido, impo tence, decrease of spermatogenesis and infertility. The LCT feminiza tion may be due directly to estrogen production or indirectly to a breakdown of excess androgens produced by the tumor cells [8]. Tes tosterone is decreased in 30-50% of the patients but the level of FSH could be either normal or elevated [7].…”