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Case report

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  2. Case report
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A 58-year-old man presented with a 3-month history of a painless mass in the left testicle. He gave a history of a delayed diagnosis of undescended right testis and had undergone right orchidectomy at the age of 53. He had fathered four children. The examination was otherwise unremarkable. Ultrasonography confirmed a solid mass in the left testicle compatible with a tumour. An orchidectomy was performed and histology revealed a Leydig cell tumour with no invasion of lymphatics or blood vessels. The histology of the previous orchidectomy was reviewed and only revealed atrophy with no apparent malignancy. Postoperative CT of the abdomen and chest showed no sign of metastases. He was subsequently commenced on hormone-replacement therapy.

Comment

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  2. Case report
  3. Comment
  4. References

There are ≈300 reported cases of Leydig cell tumour; ≈3% were bilateral and endocrinological signs were present in ≈20%. Two case reports associate cryptorchidism with Leydig cell tumours; Sufak et al. [1] reported a patient with bilateral Leydig cell tumour in association with a unilateral undescended testicle and another report described bilateral intra-abdominal testicles presenting with gynaecomastia caused by an endocrine-secreting unilateral Leydig cell tumour [2]. The only certain mode of differentiation between benign and malignant potential is the presence or absence of metastases that are highly resistant to both radio- and chemotherapy. Metastases have been known to occur even after an 8-year tumour-free interval [3]. To our knowledge this is the first reported case of a Leydig cell tumour presenting in a fertile man in the absence of tumour in the contralateral undescended testicle.

References

  1. Top of page
  2. Case report
  3. Comment
  4. References