A long list of differential diagnosis, consisting of poorly differentiated sertoli leydig cell tumor slct, sarcomatoid variant of adult granulosa cell tumor, luteinized thecoma, mitotically active fibroma, fibrosarcoma, and endometrial stromal sarcoma ess of ovary was considered initially in our case. Axiotis 2007 an indepth look at leydig cell tumor of the testis. A yearold intact male cat was submitted to castration after the finding of the enlargement of the right testis during the clinical visit. It has bimodal age incidence, involving children and adults between 30 and 60 years. Somatic tumour testing establishes that bilateral dicer1. This program was designed to help urology residents and fellows familiarize themselves with the. A leydig cell tumor of the testis is an uncommon testicular neoplasm. Pdf histogenesis and histopathological characteristics of. Precocious puberty associated with testicular hormone.
It is critical for physicians to remember and do not overlook the possibility of this rare tumor. Sertoli leydig cell tumors are rare tumors which account for less than 0. The tumor was surrounded by an incomplete, dense lamellar area. Histogenesis and histopathological characteristics of sertolileydig cell tumors. Testicular lcts can occur at any age but they are common in prepubertal boys most often between 5 and 10 years of age and in men aged 30 to 60 years. Older cryptorchid dogs greater than 6 years of age have a much higher tendency to develop. Cureus precocious puberty associated with testicular. The distinction between extensive hilus cell hyperplasia and a hilus cell tumor can be difficult, although a diameter of 1.
Degree of heterologous element differentiation is a prognostic indicator. Lct occurs over a wide age range and shows bimodal peaks. To determine the morphological and immunohistochemical pro. Total hysterectomy and bila teral salpingoophorectomy were performed. The steroid cell tumors luteoma and leydig cell tumor also are difficult to classify as benign or.
Leydig cell tumour, also leydig cell tumor us spelling, testicular interstitial cell tumour and testicular interstitial cell tumor us spelling, is a member of the sex cordstromal tumour group of ovarian and testicular cancers. Sertoli leydig cell tumors are rare sex cordstromal tumors that account for 0. Primary tumors of the testes, such as leydig cell tumors, can also serve as uncommon reason for gynecomastia. These are the accepted, unedited articles published online and citable. Leydig cell tumors are rare tumors that comprise % of all testicular neoplasms 1. The majority has been found in men between the ages of 20 and 60 years. Sertoli leydig cell tumors slcts, also known as androblastoma, belong to the sex cordstromal tumors, which exhibit a testicular pattern of differentiation.
Gynecomastia is a common incidental finding in males that can be caused by various benign or malignant diseases. Leydig cell tumors lack plap immunoreactivity allowing their distinction from seminoma in difficult cases. The more closely the tumor resembles normal tissue, the lower the tumor grade and the less aggressive it will behave. They are common in dogs and are also described in other species such as horses, cattle, cats, and man. While they can be found in women of all age groups, they are most common in young women. Leydig cell tumors represent 3% of testicular masses and usually occur in prepubertal boys and men between 30 and 60 years of age. Leydig cell tumor of the testis radiology reference. The selfexamination of testicles appears to be a very important step for the diagnosis of testicular tumors. Peter greaves mbchb frcpath, in histopathology of preclinical toxicity studies fourth edition, 2012. Sertoli cell tumor an overview sciencedirect topics. Leydig cell tumor lct is a rare tumor of the male tes ticular interstitium. Grade is usually based on microscopic features, including nuclear features.
Mucinous adenocarcinoma as heterologous element in intermediately differentiated sertoli leydig cell tumor of the ovary. Leydig cell tumor of the testis radiology reference article. Click on the title to browse this list of accepted articles. Leydig cell tumor of the testis with histological and. The aim of this report is to analyse the clinical characteristics of lct in a large patient sample and to compare these findings with corresponding data of germcell tumours gct. Adults with androgensecreting lcts are usually asymptomatic.
Treatment of poorprognosis sex cordstromal tumors of the ovary with the combination of bleomycin, etoposide, and cisplatin. Secondary leydig cell hyperplasia as bilateral testicular. Histogenesis and histopathological characteristics of sertoli leydig cell tumors article pdf available in cme journal of gynecologic oncology 72. An 80yearold man presented with a 2month history of a left testicular lump associated with mild discomfort and a gradual increase in size on a background of bilateral cryptorchidism requiring multiple orchidopexy procedures as. Seminoma, interstitial or leydig cell tumor and serto li cell tumor are the most common types with a preva lence of 33. Cd34 positive tubular basement membrane in testicular germ cell tumors.
Here we report on a 32yearold male presenting with gynecomastia which he had. Histologically, the nodule was composed by polyhedral to elongated cells with a large, eosinophilic, and vacuolated cytoplasm and small, round. The patient underwent laparoscopic left pelvic mass resection, and the histopathology of the lesion revealed sertolileydig cell tumor. A clinicopathological analysis of 40 cases of ovarian. Leydig cell tumors lcts are a sex cordstromal gonadal tumor which arise from leydig cells. Leydig cell tumors arise from the interstitial cells of leydig adjacent to the seminiferous tubules. These tumors are most commonly observed in adults aged 3060 years but may occur in infants and prepubertal children approximately 20% of cases. Histologic and immunohistochemical characterization of a. The patient had a history of primary amenorrhea and, together with the magnetic resonance imaging findings of absent uterus, short and blind end vagina, a diagnosis of androgen insensitivity syndrome was made. Diagnosis is made primarily based on palpation and findings on testicular ultrasound. Leydig cell tumors are uncommon neoplasms arising from gonadal stroma. Final diagnosis hilus or leydig cell hyperplasia upmc.
Leydig cell tumour abbreviated lct, also known as interstitial cell tumour, is an uncommon benign sex cordstromal tumour, typically seen in the testis interstitial cell tumour should not be confused with renomedullary interstitial cell tumour. In nonneoplastic testicular tissue, the seminiferous tubules showed sertoli cells with. Most often, patients present with a painless nodule or swelling of the testis. Adrenomyeloneuropathy is another example of a disease affecting the leydig cell. Sertolileydig cell tumor from latifa hospital, dubai uae. Though other tumor types are possible, testicular tumors as a whole are generally not aggressive and have a low metastatic rate. Radiology cannot distinguish between germ cell tumor and leydig cell tumor.
Leydig cell tumors see the image below are rare testicular tumors of the male gonadal interstitium that may be hormonally active and lead to. Pdf histogenesis and histopathological characteristics. The final edited and typeset version of record will appear in the future. Dec 18, 2019 in the united states, leydig cell testicular neoplasms are the most common sex cordstromal tumors and comprise % of all testicular neoplasms. An indepth look at leydig cell tumor of the testis. Leydig cell tumors are hormonally active and considered as one of the steroidsecreting tumors. This case report describes a 41yearold patient who was diagnosed with a leydig cell tumor that originated in his right testicle that subsequently metastasized to his liver, lungs. Difficult differential diagnoses in testicular pathology. Independent of tumor stage, tumor grade is an important predictor of disease outcome with higher grade tumors behaving more aggressively. We present a 5yearold boy with a fivemonth history of pubic hair appearance associated with an increase in penile length, scrotal hyperpigmentation, change in body odor, and bone age advanced by two years. A 29yearold caucasian man, born with right cryptorchidism, corrected without medical treatment before the age of two years, was diagnosed with.
Poorly differentiated sertolileydig cell tumor of ovary. Sertolileydig cell tumors genetic and rare diseases. Hyperestogenism is possible with sertoli cell tumors. Histogenesis and histopathological characteristics of sertolileydig cell tumors article pdf available in cme journal of gynecologic oncology 72. They produce testosterone, the male sex hormone responsible for the growth and maintenance of the cells of the germinal epithelium and the development of secondary sex characteristics. Leydig cell tumors lcts are rare testicular tumors that may be a cause of precocious puberty in males. We report a case of leydig cell tumor of testis in a patient presenting atypical features. While the tumour can occur at any age, it occurs most often in young adults. The varying histopathology and differentiation of this tumor present difficulties with proper diagnosis and development of optimal treatment regimens. Sertolileydig cell tumor of the ovary in a young female. Leydig cell tumor typically shows strong, diffuse cytoplasmic reactivity for. Between june 1998 and march 2009, 29 patients underwent surgery for leydig cell tumor of the testis in our cancer network. Leydig cell tumor lct is a rare testicular tumor, with malignant potential.
Testicular tumors most commonly occur in men between 20 and 35 years of age, and are the most common solid malignancy in this group. Its imaging appearance on ultrasound and mri is nonspecific, but clinically it is associated with serum hormonal imbalance. Leydig cell tumors are the most common interstitial neoplasm of the testes. Overview of sex cordstromal tumors of the ovary uptodate.
Inhibin is a sensitive and specific marker that serves to separate testicular sex cordstromal tumors including leydig cell tumor from germ cell tumors. From the department of pathology, state university of new york. Among these, slct consists of 1% of sexcord tumors. The histopathology of congenital hemangioma and its clinical. Sertoli cell tumor sct american urological association.
Here, three patients who were admitted for investigation of primary infertility and one patient presenting with a testicular mass are. Histology recapitulates the evolution of leydig cells growth patterns. His hormonal tests revealed the diagnosis of pseudo precocious puberty. About 3% cases of lct are bilateral, 1 while 10% are malignant with metastatic forms, particular to the inguinal lymph nodes and extranodal organs. Leydig cell tumors lcts are rare cordstromal tumors that may occur in testis or ovaries and may produce androgens or estrogens. These constitute dec 18, 2019 leydig cell tumors see the image below are rare testicular tumors of the male gonadal interstitium that may be hormonally active and lead to feminizing or virilizing syndromes. In a sample of 208 patients treated during 19952017 in 33 institutions, the following characteristics were registered. It is a malignant neoplasm and is one of the most treatable and curable cancers, with a survival rate above 95% if discovered in early stages. Histologic and immunohistochemical characterization of a testicular mixed germ cell sex cordstromal tumor and a leydig cell tumor in a dog m. A nontender palpable testicular mass or nodule precocious puberty in prepubertal boys wit. Leydig cell tumor is a rare form of testicular neoplasm which.
Leydig cells may grow uncontrollably and form a leydig cell tumour. Histopathology and immunohistochemistry confirmed the diagnosis of leydig cell tumor. Pathology and classification of ovarian tumors chen. Management of leydig cell tumors of the testisa case report. Welcome to the updated version of pathology for urologists. Sertolileydig cell tumour a sexcord stromal tumor, is a testostronesecreting ovarian tumor and is a member of the sex cordstromal tumour group of ovarian and testicular cancers.
In the united states, leydig cell testicular neoplasms are the most common sex cordstromal tumors and comprise % of all testicular neoplasms. Leydig cell hyperplasia has been reported in the testes of humans but it is a rare and benign condition. Frozen section diagnosis of ovarian epithelial tumors. However, a study in austria demonstrated of all patients that are undergoing surgery for testicular tumor between 1999 and 2008, leydig cell tumors accounted for 14. To the best of our knowledge, most lcts are presented as case report or as small series in the english literature. Leydig cell tumour an overview sciencedirect topics. Leydig cells interstitial or leydig cells are located in the connective tissue surrounding the seminiferous tubules. Welldifferentiated ovarian sertoli leydig cell tumors. We present the first reported case of a concomitant leydig cell tumour lct and paratesticular leiomyoma in an adult man with a history of bilateral cryptorchidism. Leydig cell tumors of the testis are rare, mostly presenting as a testicular mass or as endocrinological symptoms.
Leydig cell hyperplasia, interstitial cell hyperplasia. They are less common than leydig cell tumors of the testis. We report the caso of a 91yearold man with malignant leydig cell tumor, presenting increase of the volume of scrotum, local pain and hyperemia. A seminoma is a germ cell tumor of the testicle or, more rarely, the mediastinum or other extragonadal locations. The uncommon malignant variant, fibrosarcoma, is associated with an aggressive clinical course, but it lacks an established grading system.
Varying histopathology of sertolileydig tumors presents a diagnostic challenge. The three most common testicular tumors are seminomas, sertoli cell tumors, and interstitial cell tumors. They are rare tumors with an incidence of 1%3% of all testicular tumors and represent only 1% of all solid tumors affecting children. Two years of gynecomastia caused by leydig cell tumor.
The prognosis depends on tumors grading and staging. Sertoli cell tumor of the testis radiology reference. In leydig cell tumors orchiectomy is the elected therapeutic decision. Malignant leydig cell tumors are associated with older adult age. Leydig cell tumors see the image below are rare testicular tumors of the male gonadal interstitium that may be hormonally active and lead to feminizing or virilizing syndromes. Ramosvara animal disease diagnostic laboratory and department of comparative pathobiology, school of veterinary medicine, purdue university, west lafayette, in abstract. Ovarian sertolileydig cell tumors with pseudoendometrioid tubules pseudoendometrioid sertolileydig cell. Ovarian sertolileydig cell tumors with a retiform pattern. Sertoli cell tumors must be distinguished from sertoli cell nodules picks adenoma, which are microscopic nonneoplastic congeners of immature tubules composed of sertoli cells only that may be interspersed between leydig cells and normal seminiferous tubules. Testicular tumors knowledge for medical students and. Pdf sertoli cell tumors of the ovary are a rare group of hormonally active. Leydig cell tumors are the most common nongerm cell gonadal tumors with apparent increased incidence in the last few years. The article reports the clinical, histopathological, and immunohistochemical findings of a 1yearold boy presenting with isosexual pseudoprecocity attributable to a functioning leydig cell tumor o.
Immunoreactivity for a number of antibodies has been found in leydig cell tumors, including cam5. Leydig cell tumor lct is the most common sex cordstromal tumor and makes up 12% of all testicular tumors. Leydig cell tumor, medical imaging, pathology, testis. Diagnostic staging further includes an abdominopelvic and chest ct, determination of. Testicular leydig cell tumor with metachronous lesions. Incidental detection of sertolileydig cell tumor by fdg pet. Histopathology thyroid follicular adenoma microfollicular duration.
Ovarian leydig cell tumor in a postmenopausal patient with. Dec 22, 2019 leydig cell tumors lcts are a sex cordstromal gonadal tumor which arise from leydig cells. Sertoli leydig cell tumors tend to be unilateral and occur in women under 30 years of age. It has also been referred to as interstitial cell tumor. The tumour occurs in early adulthood not seen in newborn, is rare, comprising less than 1% of testicular tumours. Sep 18, 2014 leydig cell tumors are uncommon neoplasms arising from gonadal stroma. The aim of this report is to analyse the clinical characteristics of lct in a large patient sample and to compare these findings with corresponding data of germ cell tumours gct. Metastatic progression is historically quoted at over 10%, fuelling uncertainty as to the safety of testis sparing surgery. Leydig cell tumours lct of the testis are poorly understood clinically. An indepth look at leydig cell tumor of the testis archives of. Hilus or leydig cell tumors are included in the who classification under the heading of steroid tumors and are generally associated with a benign course. Leydig cell tumors are benign in children but can be malignant in 10% of adults. Human relevance of rodent leydig cell tumors toxicologic.
In the case of testicular tumors, cryptorchid pets pets with undescended testicles i. It is composed of round or polygonal cells with abundant eosinophilic cytoplasm resembling normal leydig cells. Mar 25, 2010 this type of tumor is sometimes called arrhenoblastoma of the ovary or a stromal tumor. Postoperative pathology showed that the tumor had cells in nets and trabeculae with chailinized and edematous stroma, without hemorrhage and necrosis or. Sertoli leydig cell tumors are a cancer that starts in the female ovaries. Tend to be bimodal, with one peak occurring in pediatric patients 510 years and one in adults 2030 years. A sertoli leydig cell tumour is a combination of a.
Some of them are hormonally active but seldom cause symptomatic endocrine disturbance. Jan 20, 2020 leydigcell tumours lct of the testis are poorly understood clinically. Pets that are cryptorchid are predisposed to the development of sertoli cell tumors and seminomas. On ultrasound, tumors are generally well defined, hypoechoic, small solid masses. Testicular tumors knowledge for medical students and physicians. Sertoli cell tumors of the testis are uncommon sex cord stromal tumors. Epidemiology may present in both pediatric and adult males, depending on the histologic subtype. This type of tumor is sometimes called arrhenoblastoma of the ovary or a stromal tumor. Sertoli leydig cell tumor slct is a rare ovarian tumor that belongs to the group of sexcordstromal tumors.
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