D. Weber, S. Krohmer (Klinik für Diagnostische Radiologie / Universität Leipzig)  

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16 Years  

Male  

Other  

neoplastic  

Male, 16 years, gynecomastia on both sides and increased estradiol values. Testicles were unremarkable without clinical difference in size or palpatory findings.  

-rare tumor: 1% of all testicular tumors
-the most Leydig-cell tumors produce testosterone or estradiol
-in children prior to puberty, a development of precocious puberty is seen. In adults/adolescents, gynecomastia is seen due to the estrogen production.
-seldom malignant, particularly in children. Malignant Leydig-Cell tumors metastasize only many years after surgery in retroperitoneal lymph nodes.  

<- view Ultrasound 1

Ultrasound 1: (13MHz-Probe) right testicle, longitudinal: 11 x 12 x 13mm, intratesticular, slightly lower in echoes, smooth edged mass with slight hyperperfusion in the border.




<- view Ultrasound 2

Ultrasound 2: (13MHz-Probe) right testicle, horizontal in comparison: 11 x 12 x 13mm, intratesticular, slightly lower in echoes, smooth edged mass with slight hyperperfusion in the border.




<- view MRI 1

MRI 1: T1-weighted before contrast: homogenic, barely demarcated mass in the right testicle.




<- view MRI 2

MRI 2: T1-weighted after application of contrast with fat saturation: Homogenic, smoothly demarcated mass with obvious contrast enhancement.




<- view MRI 3

MRI 3: T2-weighted, transversal: Homogenic, smoothly demarcated mass with decreased signal.

 

Surgery / Histo  

Other testicular tumors: i.e. Testicular carcinoma, teratoma, testicular lymphoma  

- in this patient, surgery was done 6 months earlier, which was able to save the testicles: Enucleation of the tumor with a seam of normal testicular tissue.
-there is an area of low echoes as a representation of a postoperative defect in the area of resection.
-sonographically and clinically involution of gynecomastia  

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Tumor, Leydig cell tumor, testicular tumor, gynecomastia, Testicular Leydig cell tumor, Leydig, Leydigcell, Tumor, Testis, Leydig-cell-tumor, Testosteron, Estradiol, Pubertas praecox, child, childhood, pediatric radiology  

D Weber, S Krohmer. Leydig Cell Tumor of the Testicles. PedRad [serial online] vol 4, no. 5.
URL: www.PedRad.info/?search=20040507132131