Leydig cell tumor of the testis with azoospermia and elevated delta4 androstenedione: case report

Prasivoravong, Julie; Barbotin, AL; Derveaux, A.; Leroy, Clara; Leroy, Xavier; Puech, P; Mitchell, Valérie; Marcelli, F.; Jm, Rigot

doi:10.1186/s12610-016-0041-8

Cited by 5 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, an article reported a case of unilateral orchiectomy with synchronous TESE in a patient with elevated delta 4 androstenedione and suppressed LH and FSH . Fortunately, the couple achieved a natural pregnancy because of spermatogenesis recovery after surgery.…”

Section: Discussionmentioning

confidence: 99%

Leydig cell tumor of the testis, presenting with azoospermia

Hibi

Yamashita

Sumitomo

et al. 2017

Reprod Medicine & Biology

View full text Add to dashboard Cite

CaseA case of Leydig cell tumor, associated with azoospermia, is presented.OutcomeThe levels of sex hormones obviously were decreased, including luteinizing hormone (LH) and follicle‐stimulating hormone (FSH), with elevated testosterone. Computed tomography revealed no adrenal gland tumor, but a significant calcification in the right scrotal content was observed. He received a right radical orchiectomy and then he was unable to ejaculate. An endocrine panel revealed significantly decreased levels of testosterone and the low LH level had remained. Hormone replacement therapy with combined LH and FSH successfully recovered and preserved spermatogenesis.ConclusionsAlthough the patient’s sexual function deteriorated after surgery, hormone replacement therapy was successful in establishing spermatogenesis.

show abstract

Section: Discussionmentioning

confidence: 99%

Leydig cell tumor of the testis, presenting with azoospermia

Hibi

Yamashita

Sumitomo

et al. 2017

Reprod Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…Recently, a case report of a patient with azoospermia who also had normal testosterone and suppressed gonadotropins was reported. However, this patient had high androstenedione levels, and pathology showed a Leydig cell tumor [9]. Another case report described a patient with a malignant Leydig cell tumor who presented with normal testosterone together with low LH and FSH.…”

Section: Discussionmentioning

confidence: 99%

Testicular Vein Sampling Can Reveal Gonadotropin-Independent Unilateral Steroidogenesis Supporting Spermatogenesis

LʼAbbate

Albersen

Billen

et al. 2019

Journal of the Endocrine Society

View full text Add to dashboard Cite

Suppressed gonadotropins combined with high-normal serum testosterone concentrations in oligozoospermic men suggest either use of exogenous testosterone or presence of a testosterone-producing tumor. We describe the case of a 31-year-old man referred for primary infertility. Gonadotropins were undetectably low, but testosterone and estradiol were in the high-normal range. Semen analysis showed oligoasthenospermia. He denied using exogenous testosterone. Scrotal ultrasound showed microlithiasis and millimetric hypolucent lesions in the left testis but no intratesticular mass. Human chorionic gonadotropin was low. To investigate unilateral hormone secretion, selective testicular venous sampling was performed. Testosterone and estradiol were clearly higher on the left side than on the right (130 vs 26 nmol/L and 1388 vs 62 pmol/L, respectively), with a left spermatic vein–to-periphery gradient of 4.3 for testosterone and 13 for estradiol; there were no similar gradients on the right side. This finding confirms that all sex steroid secretion came from the left testis. The patient was therefore referred for left orchidectomy. Histopathology revealed multifocal seminoma, germ cell neoplasia in situ, and Leydig cell hyperplasia but no choriocarcinoma. However, gonadotrophin levels increased after orchidectomy, indicating that the source of gonadotropin-independent sex steroid secretion was removed. Testosterone and estradiol decreased to the mid-normal range. Sperm concentration improved. This report thus shows that endogenous testosterone secretion in one testicle supports spermatogenesis without measurable levels of gonadotropins. Selective testicular venous sampling is useful to identify the site of unilateral secretion when the clinical picture is inconclusive. However, histopathology could not reveal the factor that stimulated Leydig cell steroidogenesis.

show abstract

“…Ultrasonography is considered the initial investigative method for the diagnosis of LCT and shows hypoechoic mass with a heterogeneous enhancement pattern or peripheral hypervascularity. [ 11 , 14 , 15 ] With high tissue resolution, MRI seems to be superior to ultrasonography in demonstrating the testicular lesions. [ 16 ] By comparing MRI findings in 104 patients with different testicular pathologies, Fernandez et al [ 17 ] concluded that “marked and maintained enhancement” was the characteristic sign of LCT in differentiation from other testicular tumors.…”

Section: Discussionmentioning

confidence: 99%

Management of testicular Leydig cell tumor

Zhu

Luan

2018

Medicine

View full text Add to dashboard Cite

Rationale:Testicular Leydig cell tumor (LCT) is a rare neoplasm. It commonly presents as a painless testicular mass with or without endocrine changes. Histological and immunohistochemical examination play important roles in differentiating LCT from testicular germ cell tumors.Patient concerns:We highlight the imaging phenotype, as well as the pathological findings of a case of LCT in a 62-year-old male.Diagnoses:Preoperative noncontrast CT scan of the abdomen revealed a 7.0 × 6.4 × 5.3 cm oval mass with heterogeneous density, located in the right testis. Pelvic noncontrast MRI showed a heterogeneous mass on T1-weighted and T2-weighted images. The solid part of the tumor exhibited high signal on the diffusion-weighted imaging, and an obvious enhancement on the contrast-enhanced MR imaging. Ultrasonography examination demonstrated a large mixed echogenic space occupying lesion involving the whole right testis with multiple cystic areas and increased vascularity. This patient underwent radical orchiectomy. The pathologic diagnosis was LCT.Interventions:This patient underwent operative resection of the tumor. Due to the negative resection margins and absence of distant metastases, the patient did not receive additional radiotherapy or chemotherapy.Outcomes:Four months after the surgery, the follow-up CT-scan did not reveal any local recurrence and distant metastases.Lessons:This case improves our ability to detect and diagnose LCT by summarizing its imaging characteristics as well as reviewing the literature. Additionally, we described the state-of-the-art management of the management of this rare tumor.

show abstract

Leydig cell tumor of the testis with azoospermia and elevated delta4 androstenedione: case report

Cited by 5 publications

References 20 publications

Leydig cell tumor of the testis, presenting with azoospermia

Leydig cell tumor of the testis, presenting with azoospermia

Testicular Vein Sampling Can Reveal Gonadotropin-Independent Unilateral Steroidogenesis Supporting Spermatogenesis

Management of testicular Leydig cell tumor

Contact Info

Product

Resources

About