Pure Leydig cell tumor: a rare case report

Abstract

Leydig cell tumors are rare tumors and constitute 1-3% of all testicular tumors. The pure form of these tumors, which are often found in mixed form with sertoli cells, is extremely rare. It is very difficult to determine the malignancy potential in leydig cell tumors most commonly manifested by a testicular mass or endocrine symptoms. In this study, clinical, histological and prognostic features of a pure form of Leydig cell tumors are presented in the light of literature information.

Keywords

• Leydig cell tumor,testicular tumors,endocrine manifestation

Saf Leydig hücresi tümörü: nadir bir olgu sunumu

Abstract

Leydig hücre tümörleri (LCT) nadir tümörler olup tüm testiküler tümörlerin% 1-3'ünü oluşturur. Sıklıkla sertoli hücreleri ile karışık formda bulunan bu tümörlerin saf formu son derece nadirdir. Testiküler kitle veya endokrin semptomları ile en sık görülen leydig hücresi tümörlerinde malignite potansiyelini belirlemek çok zordur. Bu çalışmada, saf Leydig hücre tümörleri formunun klinik, histolojik ve prognostik özellikleri literatür bilgileri ışığında sunulmuştur.

Keywords

• Leydig hücre tümörü,testis tümörleri,endokrin tezahürü

References

1. 1. Dilworth JP, Farrow GM, Oesterling JE. Non-germ cell tumors of testis. Urology 1991; 37: 399–417.
2. 2. Emerson RE, Ulbright TM: Morphological approach to tumours of the testis and paratestis. J Clin Pathol 2007; 60: 866–80.
3. 3. Cheville JC: Classification and pathology of testicular germ cell and sex cord-stromal tumors. Urol Clin North Am 1999; 26: 595–609.
4. 4. Leonhartsberger N, Ramoner R, Aigner F, et al. Increased incidence of Leydig cell tumours of the testis in the era of improved imaging techniques. BJU Int 2011; 108: 1603–07.
5. 5. Giacaglia LR, Kohek MB da F, Carvalho FM, Fragoso MC, Mendonca B, Latronico AC. No evidence of somatic activating mutations on gonadotropin receptor genes in sex cord stromal tumors. Fertil Steril 2000; 74: 992–5.
6. 6. Libe R, Fratticci A, Lahlou N, et al. A rare cause of hypertestosteronemia in a 68-year-old patient: a Leydig cell tumor due to a somatic GNAS (guanine nucleotide-binding protein, alpha-stimulating activity polypeptide 1)-activating mutation. J Androl 2012; 33: 578–84.
7. 7. Carvajal-Carmona LG, Alam NA, Pollard PJ, et al. Adult leydig cell tumors of the testis caused by germline fumarate hydratase mutations. J Clin Endocrinol Metab 2006; 91: 3071–5.
8. 8. Lejeune H, Habert R, Saez JM. Origin, proliferation and differentiation of Leydig cells. J Mol Endocrinol 1998, 20: 1–25.

9. 9. Butruille C, Marcelli F, Ghoneim T, et al. Management of testicular lesions in a population of infertile patients. Prog Urol 2012; 22: 45–52.
10. 10. Hekimgil M, Altay B, Yakut BD, Soydan S, Ozyurt C, Killi R. Leydig cell tumour of the testis: comparison of histopathological and immunohistochemical features of three azoospermic cases and one malignant case. Pathol Int 2001; 51: 792-6.
11. 11. Kaufman E, Akiya F, Foucar E, Gambort F, Cartwright KC. Virilization due to Leydig cell tumor diagnosis by magnetic resonance imaging: case management report. Clin Pediatr 1990; 29: 414-7.
12. 12. Maeda T, Itoh N, Kobayashi K, Takahashi A, Masumori N, Tsukamoto T. Elevated serum estradiol suggesting recurrence of Leydig cell tumor nine years after radical orchidectomy. Int J Urol 2002; 9: 659-61.
13. 13. Ulbright TM, Srigley JR, Hatzianastassiou DK, Young RH. Leydig cell tumours of the testis with unusual features: adipose differentiation, calcification with ossification, and spindle-shaped tumour cells. Am J Surg Pathol 2002; 26: 1424-33.
14. 14. Palazzo JP, Petersen RO, Young RH, Scully RE. Deoxyribonucleic acid flow cytometry of testicular Leydig cell tumors. J Urol 1994; 152: 415–7.
15. 15. Henderson CG, Ahmed AA, Sesterhenn I, Belman AB, Rushton HG. Enucleation for prepubertal leydig cell tumor. J Urol 2006; 176: 703–5.
16. 16. Bertram KA, Bratloff B, Hodges GF, Davidson H. Treatment of malignant Leydig cell tumor. Cancer 1991; 68: 2324–9.
17. 17. Hekimgil M, Altay B, Yakut BD, Soydan S, Ozyurt C, Killi R. Leydig cell tumor of the testis: comparison of histopathological and immunohistochemical features of three azoospermic cases and one malignant case. Pathol Int 2001; 51: 792–6.
18. 18. Trabert B, Zugna D, Richiardi L, McGlynn KA, Akre O. Congenital malformations and testicular germ cell tumors. Int J Cancer 2013; 133: 1900–4.