Early diagnosis of Leydig-cell tumor: Case report

The Leydig-cell tumor is a neoplasia which represents 1-3% of all testicular tumors. It is malignant in about 10% of cases. The tumor cells are able to produce androgens, estrogens and corticosteroids, so that disendocrine syndromes may be present from childhood. In adult subjects the first symptom is gynecomastia in about 24-26% of cases. Therefore in cases of adult gynecomastia testicular sonography is mandatory. This tumor is usually treated by orchiectomy and cordectomy but in case of early diagnosis a conservative treatment should be possible. A 5-year follow-up with imaging and hormonal investigation is recommended, after which the patient can be considered cured. In the present article we describe an interesting clinical case with a very small tumor, giving gynecomastia even though hormonal abnormalities were undetectable by common laboratory tests.