陳致豪、劉建良、黃冠華

奇美醫學中心 外科部 泌尿科

 

 

Leydig cell tumor are rare testicular tumor. Most of them are benign, but sometimes malignant. Leydig cell tumor had poor response to medical therapy, such as chemotherapy and radiotherapy. We described a case of left scrotal mass. The patient underwent radical orchiectomy and the pathology report showed a rare diagnosis of Leydig cell tumor.

 

A 39-year-old male found himself to have left scrotal firm mass for 3 weeks. He went to our outpatient department for help. Physical examination showed left scrotal firm and painless mass. Tumor markers (β-HCG and AFP) were within normal limit. Scrotal sonography showed a well-defined isoechoic mass in the left testis, about 3.3 x 2.9 x 3.5 cm with internal vascularity. Left radical orchiectomy was performed smoothly. Operative findings showed hardening of the left testis about 4cm in size, with intact tunica albuginea. Pathology report showed a yellow soft tumor with capsule, locating at the center of testis, measuring 3.2 x 3 x 2.6 cm, composed of neoplastic cells forming large nodules separated by collagenous stroma, with focal ribbon-liked, and microcystic pattern. Leydig cell tumor was confirmed. The patient had stable condition after the operation and discharged smoothly on POD 2.

 

Medical treatment plays little role on Leydig cell tumor. Some literature revealed the possibility of testis-sparing orchiectomy. Main surgical choice is still radical orchiectomy, which could have correct diagnosis and have good prognosis.