Leydig cell tumors of the testis: a case report

Abstract

BackgroundLeydig cell tumors are the most common non-germ cell gonadal tumors with apparent increased incidence in the last few years. They are usually benign tumors. We report a case of Leydig cell tumor of testis in a patient presenting atypical features.Case presentationA 29-year-old Caucasian man, born with right cryptorchidism, corrected without medical treatment before the age of two years, was diagnosed with Leydig cell tumor. Two years after diagnosis was identified moderately elevated estradiol serum level, in the context of a significant overweight, hormonal changes which had maintained after unilateral orchiectomy and after the patient's return to normal weight. Four years after unilateral orchiectomy, elevated value of estradiol persisted and subdiaphragmatic micro lymphadenopathy was observed.ConclusionsDespite the favorable evolution of the patient four years after unilateral orchiectomy, long-term follow-up is necessary to exclude recurrence or metastasis to the testis. The endocrine profile and imaging investigations need to be repeated periodically. The changes in the hormonal assay and any new aspects on computed tomography scan can be used as a marker of tumor recurrence and require careful screening and the correct therapeutic decisions.

Leydig cell tumor of the testis, presenting with azoospermia

“…Despite the favorable outcome of one patient 4 years after his orchietomy, elevated estradiol and retroperitoneal lymph node swellings were observed . Another study also reported a patient who presented with a hormone‐secreting interstitial tumor of the testis and who developed metastasis 7 years after the removal of a benign primary tumor .…”

“…Immunohistochemically, the tumor cells were positive for inhibin-alpha and Melan-A ( Figure 3C Despite the favorable outcome of one patient 4 years after his orchietomy, elevated estradiol and retroperitoneal lymph node swellings were observed. 5 Another study also reported a patient who presented with a hormone-secreting interstitial tumor of the testis and who developed metastasis 7 years after the removal of a benign primary tumor. 6 In conclusion, Leydig cell tumors are rare and show variable endocrinological findings, depending on their ability to secrete steroid hormones.…”

Leydig cell tumor of the testis presenting with gynaecomastia due to hyperprolactinemia after orchiectomy

“…[23,24] Tumor markers differentiate testicular malig-nancy before one can stick to endocrinal syndrome. Pure LCT do not produce any tumor markers [23,24] as it occurred in our patient.…”

A rare testicular tumor with elevated alkaline phosphatase

“…Leydig cell tumor is a rare germ cell tumor that originates from gonadal stroma, accounting for about 15 to 3% of testicular neoplasms in adults and about 4% in pediatric patients who have not yet reached maturity (1). Leydig cells are named after Franz Leydig.…”