Title: Malignant Leydig Cell Tumor of Testis: Case Report
Authors: Dr Himani Thakur, Dr Sarita Asotra, Dr Kavita Mardi, Dr Kailash Mohan Bhandari, Dr Kavita Kumari
DOI: https://dx.doi.org/10.18535/jmscr/v12i05.01
Abstract
Testicular tumors accounts for % of the tumors in men. 5% of which are the sex cord stromal tumors and the remaining are of germ cell origin. Leydig cell are the common subtype of Sex cord stromal tumors and accounts for 1%-2% of all the testicular tumors. Tumor arises from the leydig cells that normally reside in the interstitium of testicles and secrete testosterone in the presence of leutenizing hormone. They show a bimodal distribution with peaks in the prepubertal age group and between 30-60yrs of age. Leydig cell tumor being a hormonally active tumor often presents with precocious puberty, breast tenderness and gynaecomastia. Histopathology reveals a well circumscribed mass .Cut surface shows golden brown homogenous appearance. Microscopically, tumor cells are large to polygonal with round to oval nucleus with deeply granular cytoplasm. Cytoplasm shows characteristics rod sghaped crystals referred to as “ crystalloids of Reinke”. Leydig cell tumors are mostly follow a benign course but approximately 5-10% of these have malignant potential. Regional lymph nodes, lungs , liver and bones are the commonest sites of metastsis. Due to aggressive difficult to treat nature of metastatic disease it is essential to differentiate benign leydig cell tumor from its malignant counterpart in order to guide its initial surgical and radiological management. Assessment of the clinicopathological features of Leydig cell tumor allows for its optimal management.