Ten-year indolent evolution of a Leydig cell tumor: A case report and literature review

TL;DR

A rare case of a slow-growing, benign Leydig cell tumor in a 45-year-old man is reported, highlighting the importance of early detection and long-term monitoring.

Contribution

This case report adds to the limited literature on indolent Leydig cell tumors and emphasizes the evolving approach to diagnosis and treatment.

Findings

The tumor was detected via ultrasound and confirmed as benign through histopathology.

The case supports the trend toward testis-sparing surgery over radical orchiectomy.

Long-term surveillance is recommended due to the potential for metastasis in adult Leydig cell tumors.

Abstract

Leydig cell tumors (LCTs) are rare sex cord-stromal neoplasms that pose diagnostic challenges due to their overlap with germ cell tumors. This report describes a 45-year-old male with a 10-year history of a slow-growing, painless testicular mass. Preoperative imaging revealed a hypervascular, hypoechoic nodule. Histopathological analysis following a radical orchiectomy confirmed a benign LCT characterized by polygonal cells with eosinophilic cytoplasm and absent mitotic activity. The case emphasizes the shift toward early detection via ultrasound and highlights the necessity of long-term surveillance to monitor the metastatic potential inherent in adult LCTs.

•Reports a rare benign Leydig cell tumor in a 45-year-old asymptomatic male.•Hypervascular, hypoechoic ultrasonography features aided early tumor detection.•Histopathology confirmed pT1a staging with a distinct absence of mitotic activity.•Discusses radical orchiectomy versus the trend toward testis-sparing surgery.•Emphasizes the necessity of long-term surveillance for adult stromal neoplasms.

Reports a rare benign Leydig cell tumor in a 45-year-old asymptomatic male.

Hypervascular, hypoechoic ultrasonography features aided early tumor detection.

Histopathology confirmed pT1a staging with a distinct absence of mitotic activity.

Discusses radical orchiectomy versus the trend toward testis-sparing surgery.

Emphasizes the necessity of long-term surveillance for adult stromal neoplasms.

Figures