ECE2020 ePoster Presentations Reproductive and Developmental Endocrinology (37 abstracts)
A nonpalpable leydig cell tumor and gynecomastia: A case report
Wafa Benothman , Imen Halloul , Asma Ben Abdelkrim , Ghada Saad , Yosra Hasni , Molka Chaeib , Maha Kacem , Amel Maaroufi & Koussay Ach
Farhat Hached Hospital, Endocrinology, Sousse, Tunisia
Introduction: Leydig cell tumors (LCTs) are uncommon neoplasms arising from gonadal stroma, accounting for 1–3% of all testicular tumors in adults. The etiology of LCT remains unclear. About 25% of LCTs secrete predominantly estrogens, which produce gynecomastia.
Observation: We report a case of a 53-year-old male patient who sought evaluation for bilateral gynecomastia. He had a long-term use of amitriptyline and benzodiazepine. The physical examination of the testicles was normal. A left testicular tumor was found on echographic analysis. The serum germ cell tumor markers showed no significant abnormalities. Radical left orchidectomy was performed by an inguinal approach. The anatomopathological study disclosed a LCT as the immunostaining showed that the tumor cells were positive for inhibin and calretinin. There were no cytological signs of malignancy or evidence of metastasis. Two years and a half after the surgery, the follow-up CT-scan did not reveal any local recurrence and distant metastases. Hormonal investigations showed moderately elevated estradiol level and low level of testosterone at 2.3 ng/ml, while tumor markers AFP and β-hCG were still negative. The gynecomastia persisted as well.
Conclusion: In the last few years, the incidence of LCTs seemed to increase well above the literature predictions. A hormonal study and scrotal ultrasound evaluation should be performed even in the absence of palpable testicular tumors. Complete recovery of both endocrine and exocrine testicular function is not guaranteed. This may be secondary to a slowly reversible (or irreversible) estrogen-induced damage to tubular and leydig cells.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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