# 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.

## Key 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.