Leydig cell tumor of the testis

Case contributed by Dr Hisham Alwakkaa

Presentation

Bilateral testicular pain.

Patient Data

Age: 17
Gender: Male
Ultrasound

pre-surgery ultrasound study

Small hypoechoic nodule in the mid portion of the right testis. Some internal vascularity detected on color Doppler images. Findings are consistent with testicular neoplasm. 

Ultrasound

Post partial orchiectomy-followup ultrasound

There is a hypoechogenic avascular area with irregular borders extending vertically through the mid portion of the right testis, consistent with surgical scar.

Case Discussion

This is a case of benign Leydig cell tumor diagnosed 4 years ago. The patient underwent a partial orchiectomy and he has been followed since then, and the above ultrasound follow-up study is the latest one.

All of tumor work-up (tumor markers and CT torso, bone scan) at the time of diagnosis came back negative. Because of that; in addition to the young age of the patient, small size of the nodule and most importantly the frozen pathology result at the time of the surgery that revealed that the tumor most likely to be benign, the urology team had decided to perform partial orchiectomy.  

Summary of the pathology report:

 

Diagnosis: Benign Leydig cell tumor.

Tumor size: 0.5 cm

Margins: Non-infiltrative

Necrosis: Absent.

Nuclear atypia: Minimal to Mild

Mitosis: Approximately Five per 10 HPF

MIB-1 activity: Approximately 4-5 %

Lymphatic and vascular invasion: not seen.

 

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Case information

rID: 57509
Published: 29th Dec 2017
Last edited: 14th Aug 2019
System: Oncology
Inclusion in quiz mode: Included
Institution: Women and children Hospital of Buffalo

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