Abstract

LOPEZ MARTINEZ, Sara; ALRAMADAN ALJMALAH, Mubarak; CABO RIPOLL, Mónica de  and  TORRECILLA FERNANDEZ, Francisco Javier. Gynecomastia and hypogonadotropic hypogonadism caused by Leydig cell tumor: a rare cause of testicular tumor. Rev Clin Med Fam [online]. 2020, vol.13, n.1, pp.76-80.  Epub Apr 20, 2020. ISSN 2386-8201.

Leydig cell tumors are rare and account for a small proportion of testicular neoplasms (1-3%). They most frequently present as a painless testicular mass or as an incidental ultrasound finding, accompanied by hormonal disorders in more than 80% of cases. Serum tumor markers are negative and approximately 30% of cases present gynecomastia. The treatment of choice is surgery (inguinal orchiectomy) with a long post-operative follow-up. The definitive diagnosis is histological, which will be carried out during or after surgery. The immunohistochemical markers of Leydig cell tumors include inhibin alpha, calretinin, and melan-A. The presence of the inhibin alpha subunit in immunohistochemical analysis shows intense positivity of tumor cells compared with the surrounding healthy tissue. Calretinin is more sensitive but less specific than inhibin. Melan-A is a moderately sensitive and specific marker of sex cord-stromal tumors, and, as such, complements other immunohistochemical markers in the assessment of tumors which are difficult to diagnose. The interest of this case is to show the complex pattern of clinical presentation of these tumors, and to establish a differential diagnosis with other testicular tumors.

Keywords : Gynecomastia; Hypogonadism; Leydig Cell Tumor.

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