ABSTRACT
Recently we reported expressional alterations in 219 genes and their transcripts in Leydig cell tumors but nowadays there is still a lack of full basic biochemical characteristics of these tumors. The discovery of potential biochemical markers for tumor management from early detection, treatments, and control of therapy results may markedly supplement genetic data. Leydig cell micronodules were obtained from patients with azoospermia who were qualified for testicular biopsy. The biochemistry of Leydig cell tumors was analyzed using histological staining and spectrophotometric measurements of total proteins, carbohydrates, lipids, and nucleic acids. In addition, the levels of calcium (Ca2 +), copper (Cu2 +), zinc (Zn2 +), and selenium (Se2 +) ions were measured. When compared to healthy testis we revealed, for the first time, that in the interstitial tissue with Leydig cell tumors, great amounts of proteins, carbohydrates, lipids, and acids were dislocated from the seminiferous tubules. Measurements of organic compounds showed a decrease (P < 0.05) only in the Cu2 + content in Leydig cell tumors which may be related to their altered biochemical structure. This specific result may be promising for designing further approaches to manage this tumor based on combining morphological and molecular data.
Subject(s)
Leydig Cell Tumor , Testicular Neoplasms , Humans , Male , Leydig Cell Tumor/pathology , Leydig Cell Tumor/metabolism , Testicular Neoplasms/pathology , Testicular Neoplasms/metabolism , Adult , Copper/metabolism , Testis/pathology , Testis/metabolism , Zinc/metabolism , Selenium , Calcium/metabolism , Azoospermia/metabolism , Azoospermia/pathology , Leydig Cells/metabolism , Leydig Cells/pathologyABSTRACT
BACKGROUND: Testicular Leydig cell tumours (LCTs) are the most common type of sex cord-stromal tumour in men, representing 1%-3% of all testicular neoplasms. Among testicular sex cord-stromal tumours, CTNNB1 mutations and nuclear expression of ß-catenin have been typically associated with Sertoli cell tumour. Recent genomic analyses have shown that CTNNB1 variants are also identified in a subset of LCTs; however, the frequency and clinicopathologic associations of ß-catenin alterations remain incompletely understood in this tumour type. METHODS: In this study, we evaluated 32 LCTs (five malignant/metastasizing, 27 nonmetastasizing) using ß-catenin immunohistochemistry and DNA sequencing. RESULTS: Immunohistochemistry revealed focal or multifocal nuclear ß-catenin expression in 47% of the tumours. Diffuse nuclear ß-catenin expression (in >50% of the tumour cells) was not detected in any of the cases analysed herein. Comparison of ß-catenin-positive and ß-catenin-negative cases did not show significant differences in the frequency of adverse histopathologic findings or malignant clinical behaviour. DNA sequencing performed de novo on a subset of seven cases revealed the presence of exon 3 CTNNB1 variants in four of them (4/7, 57%), with variant allele frequencies (VAF) ranging from 7 to 33%. Two additional ß-catenin-positive cases that had been sequenced as part of a previous study harboured exon 3 CTNNB1 variants at VAF of 28% and 7%, respectively. CONCLUSION: These results demonstrate that ß-catenin alterations are relatively common in LCT, most likely occurring as subclonal events that are not enriched in cases with aggressive features. Further studies are needed to clarify the oncogenic role of ß-catenin in this tumour type.
Subject(s)
Immunohistochemistry , Leydig Cell Tumor , Testicular Neoplasms , beta Catenin , Humans , beta Catenin/genetics , beta Catenin/metabolism , Male , Testicular Neoplasms/pathology , Testicular Neoplasms/genetics , Testicular Neoplasms/metabolism , Leydig Cell Tumor/pathology , Leydig Cell Tumor/metabolism , Leydig Cell Tumor/genetics , Adult , Middle Aged , Aged , Young Adult , Adolescent , Mutation , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolismABSTRACT
Los tumores de células de Leydig son raros y suponen una pequeña proporción de neoplasias testiculares (1-3 %). La forma más frecuente de presentación es una masa indolora testicular o un hallazgo ecográfico incidental acompañado en más del 80 % de los casos de desórdenes hormonales. Los marcadores tumorales séricos son negativos y aproximadamente el 30 % de los casos presentan ginecomastia. El tratamiento de elección es la cirugía (orquiectomía ingui-nal) y el seguimiento postoperatorio será prolongado. El diagnóstico definitivo es histológico y se realizará durante o tras la cirugía. Entre los marcadores inmunohistológicos de tumores de células de Leydig se incluyen alfa inhibina, calretinina y melan A. La presencia de la subunidad alfa de inhibina mediante técnica de inmunohistoquímica, destaca la intensa positividad de las células tumorales en comparación con la del tejido sano circundante. La calretinina es más sensible pero menos específica que la inhibina. Melan A es un marcador moderadamente sensible y específico en la diferenciación de tumores del estroma del cordón sexual y como tal es un valor complementario a otros marcadores inmunohistoquímicos en la valoración de tumores de difícil diagnóstico. El interés de este caso es mostrar la complejidad de alteraciones clínicas asociadas a estos tumores, así como establecer un diagnóstico diferencial con otros tumores histológicos
Leydig cell tumors are rare and account for a small proportion of testicular neoplasms (1-3%). They most frequently present as a painless testicular mass or as an incidental ultrasound finding, accompanied by hormonal disorders in more than 80% of cases. Serum tumor markers are negative and approximately 30% of cases present gynecomastia. The treatment of choice is surgery (inguinal orchiectomy) with a long post-operative follow-up. The definitive diagnosis is histological, which will be carried out during or after surgery. The immunohistochemical markers of Leydig cell tumors include inhibin alpha, calretinin, and melan-A. The presence of the inhibin alpha subunit in immunohistochemical analysis shows intense positivity of tumor cells compared with the surrounding healthy tissue. Calretinin is more sensitive but less specific than inhibin. Melan-A is a moderately sensitive and specific marker of sex cord-stromal tumors, and, as such, complements other immunohistochemical markers in the assessment of tumors which are difficult to diagnose. The interest of this case is to show the complex pattern of clinical presentation of these tumors, and to establish a differential diagnosis with other testicular tumors
Subject(s)
Humans , Male , Young Adult , Gynecomastia/diagnosis , Hypoadrenocorticism, Familial/diagnosis , Hypogonadism/diagnosis , Testicular Neoplasms/pathology , Leydig Cell Tumor/pathology , Diagnosis, Differential , Varicocele/diagnosis , Seminoma/pathologyABSTRACT
ABSTRACT Testicle tumors are a rare entity among men population, accounting for only 1-1.5% of all cancers among men. The stromal tumors of the sexual cord correspond just 4% of all testicular cancers. Only 10% of them are malignant. The major representative of the sex cord-stromal tumors is the Leydig cell tumor, corresponding to 75 to 80% of the total. It has bimodal age incidence, involving children and adults between 30 and 60 years. We report the caso of a 91-year-old man with malignant Leydig cell tumor, presenting increase of the volume of scrotum, local pain and hyperemia. The are few cases in the literature, only 1 with pacient above 85 years old.
Subject(s)
Humans , Male , Testicular Neoplasms/pathology , Leydig Cell Tumor/pathology , Scrotum/pathology , Testicular Neoplasms/immunology , Rare Diseases , Leydig Cell Tumor/immunology , Antibodies, NeoplasmABSTRACT
Presentamos un caso de una mujer menopáusica de 56 años con clínica de hirsutismo progresivo severo de 7 meses de evolución. Entre otras pruebas, se realizó una ecografía transvaginal en el que se observaron unos anejos estrictamente normales. Ante la sospecha de patología ovárica debido a la ausencia de patología suprarrenal y test de frenación con análogos de la GnRh positivo, se solicitó una RMN pélvica que identificó una pequeña tumoración sugestiva de tumor del estroma ovárico. Se realizó una ooforectomia bilateral laparoscópica. El estudio anatomopatológico informó de tumor de células esteroideas (Tumor de células de Leydig). La clínica de virilización mejoró progresivamente después de la intervención
We report the case of a menopausal 56-year-old woman with severe progressive hirsutism with 7 months of evolution. Among other tests, a transvaginal Doppler Ultrasound was performed, revealing strictly normal ovaries. Due to the absence of suprarenal pathology and that the results of the gonadotropin-releasing hormone agonist test turned out positive, suggesting ovarian pathology, a Pelvic MRI was ordered. The results showed a small tumour suggestive of ovarian tumour stroma, so surgery was performed. The results of anatomical pathology reported Leydig cells tumour. Symptoms of virilisation improved progressively after the surgery
Subject(s)
Humans , Female , Middle Aged , Virilism/etiology , Ovarian Neoplasms/complications , Hirsutism/etiology , Hyperandrogenism/etiology , Ovarian Neoplasms/pathology , Leydig Cell Tumor/pathology , Risk FactorsABSTRACT
OBJETIVOS: Los tumores testiculares (TT) y paratesticulares (TP) constituyen el 1-2% de los tumores sólidos infantiles. Estudios recientes recomiendan un manejo conservador, ante la mayor frecuencia de tumores benignos. Con estas premisas, revisamos nuestra experiencia, así como la actitud terapéutica adoptada. MÉTODOS: Todos los TT y TP tratados desde 1998 hasta 2016 se analizaron de manera retrospectiva. Entre los datos recogidos se encuentran la edad, clínica, lateralidad de la tumoración, pruebas de imagen, tratamiento realizado, tipo histológico y evolución. RESULTADOS: Se revisaron un total de 19 casos de TT y TP en 17 pacientes. El 79% de los casos debutaron como una masa escrotal asintomática con marcadores tumorales negativos. El estudio anatomopatológico demostró una proporción similar de TT estromales y de células germinales. En cuanto a los TP se evidenció una proporción similar entre los tumores de características benignas y malignas. Se practicó cirugía conservadora en el 58% de los TT y tumorectomía en el 57% de los TP. CONCLUSIONES: La alta incidencia de benignidad de los TT y TP en la infancia, sobre todo con marcadores tumorales normales, hace que deba considerarse la cirugía conservadora como primera opción terapéutica
OBJECTIVES: Testicular (TT) and paratesticular (PT) tumors account for 1-2% of all infant solid tumors. Due to the increased frequency of benign tumors, conservative management is recommended. Our experience and the therapeutic approach adopted considering testis-sparing surgery, was reviewed. METHODS: A retrospective observational study concerning testicular and paratesticular tumors in our hospital between 1998 and 2016, was performed. Age, side, symptoms, imaging, treatment methods, histological findings and evolution were reviewed. RESULTS: Nineteen cases of TT and PT were reviewed in 17 patients. A painless scrotal mass was found in most cases as the initial presentation (79%). Tumor markers were normal in all cases. Similar distribution between germ cell and stromal testicular tumors was found. Nevertheless, benign and malignant PT proportion was similar. Testis preserving surgery was performed in 58% of TT and in 57% of PT. CONCLUSIONS: Due to the high incidence of the benign histological findings, testicular sparing surgery should be considered as a first therapeutic option, especially in those cases with normal tumor markers
Subject(s)
Humans , Male , Female , Child , Testicular Neoplasms/congenital , Testicular Neoplasms/pathology , Pediatrics/methods , Orchiectomy/methods , Cysts/diagnosis , Ultrasonography/methods , Testicular Hydrocele/pathology , Leydig Cell Tumor/pathology , Hemangioma/pathology , Biopsy/methods , Testicular Neoplasms/complications , Testicular Neoplasms/diagnosis , Retrospective Studies , Orchiectomy/standards , Cysts/complications , Ultrasonography/instrumentation , Testicular Hydrocele/diagnosis , Leydig Cell Tumor/metabolism , Hemangioma/blood , BiopsyABSTRACT
ABSTRACTObjectives:Ultrasound (US) is often used for the work-up of testicular pathology. The findings may implicate on its management. However, there is only scant data on the correlation between US findings and testicular tumor type and size. Herein, we report on a multicenter study, analyzing these correlations.Methods:The study included patients who underwent orchiectomy between 2000 and 2010. Their charts were reviewed for US echogeneity, lesion size, pathological dimensions, histology, and the presence of calcifications, fibrosis, necrosis and/or intraepithelial neoplasia. The incidence of these parameters in benign versus malignant lesions and seminomatous germ cell tumors (SGCT) versus nonseminomatous germ cell tumors (NSGCT) was statistically compared.Results:Eighty five patients fulfilled the inclusion criteria, 71 malignant (43 SGCT, 28 NSGCT) and 14 benign. Sonographic lesions were at least 20% smaller than the pathologically determined dimensions in 21 (25%) patients. The ability of US in estimating the size of malignant tumors was 71%, compared to 100% of benign tumors (p=0.03), with no significant difference between SGCT and NSGCT. Necrosis was more frequent in malignant tumors (p=0.03); hypoechogeneity and fibrosis were more frequent in SGCT than in NSGCT (p=0.002 and 0.04 respectively).Conclusions:Testis US of malignant lesions underestimates the size in 25% of the cases, a fact that may impact on the decision of testicular sparing surgery. The ultrasonic lesions were eventually proven to be benign in 16% of the cases. Therefore it is advised to apply frozen sections in borderline cases. Hypoechogeneity is more frequent in SGCT than NSGCT.
Subject(s)
Humans , Male , Orchiectomy/statistics & numerical data , Seminoma , Tumor Burden , Testicular Neoplasms , Testis , Fibrosis , Frozen Sections , Leydig Cell Tumor/pathology , Leydig Cell Tumor , Necrosis , Organ Size , Predictive Value of Tests , Retrospective Studies , Seminoma/pathology , Testicular Neoplasms/pathology , Testis/pathologyABSTRACT
La combinación de hemangioma capilar (HC) lobulado testicular con hiperplasia de células de Leydig es excepcional. Presentamos un caso en un varón de 72 años, con antecedente de seminoma testicular izquierdo hace 34 años, que consultó por asimetría mamaria. El estudio ultrasónico testicular mostró en el testículo derecho una lesión sólida, hipoecogénica, de 0,6 cm, con flujo vascular central y periférico. Los niveles de β-HCG, LH, estradiol y testosterona fueron normales. Mediante cirugía conservadora, con enucleación de la lesión, y biopsia intraoperatoria se confirmó la benignidad de la lesión. De acuerdo con lo revisado en la literatura, el presente caso sería el primer HC asociado a hiperplasia de células de Leydig en un adulto mayor (AU)
Lobulated capillary hemangioma with Leydig cell hyperplasia in the same nodule is exceptional. We report a case of a 72 year old male presenting with mammary asymmetry. Thirty seven years previously he had had a left sided testicular seminoma. Testicular ultrasonography of the right testicle revealed a 0.6 cm hypoecogenic nodule, which was solid with central and peripheral vascular flux. Beta-HCG, LH, estradiol and total testosterone levels were normal. Enucleation of the lesion was performed and an intraoperatory biopsy confirmed a benign lesion. The definitive diagnosis was lobulated capillary hemangioma with Leydig cell hyperplasia. To our knowledge, this is the first case reported in an adult (AU)
Subject(s)
Humans , Male , Aged , Testicular Neoplasms/surgery , Seminoma/surgery , Granuloma, Pyogenic/pathology , Orchiectomy , Leydig Cell Tumor/pathology , GynecomastiaABSTRACT
Los tumores de células de Leydig (TCL) en niños son escasos, con una incidencia de 1-3% de todos los tumores testiculares en niños. Su presentación clínica es masa testicular, dolor y alteraciones hormonales como pubertad precoz o ginecomastia. Presentamos un caso de TCL y su manejo conservador luego de su hallazgo incidental. Se revisó la literatura (AU)
Leydig Cell Tumors (LCT) in children are very rare, with an incidence of 1-3% for all testicular tumors in children. Clinical presentation is testicular mass, pain and hormone alteration such as precocious puberty and gynecomastia. We present one case of LCT and his conservative management after an incidental finding. Literature is reviewed (AU)
Subject(s)
Humans , Male , Adolescent , Leydig Cell Tumor/complications , Leydig Cell Tumor/diagnosis , Leydig Cell Tumor/pathology , Testicular Neoplasms/complications , Testicular Neoplasms/diagnosis , Testicular Neoplasms/surgery , Incidence , Puberty, Precocious/complications , Puberty, Precocious/diagnosis , Gynecomastia/complications , Gynecomastia/diagnosisABSTRACT
OBJETIVOS: Tumores testiculares são uma rara condição associada à hiperplasia adrenal congênita (HAC) que decorrem da hiperplasia de restos adrenais intratesticulares (HRA), raramente ocorrendo associados a neoplasias malignas. Sua diferenciação histológica com tumores de células de Leydig é muito difícil, podendo levar a orquiectomias desnecessárias. O objetivo deste relato foi apresentar esse dilema diagnóstico em um paciente com HAC e tumores testiculares bilaterais. MÉTODOS: Relatou-se o caso de um paciente masculino, 16 anos, com diagnóstico de HAC desde os 3 anos de idade, que apresentava tumorações testiculares endurecidas, indolores e de crescimento lento, sendo encaminhado para orquiectomia bilateral. RESULTADOS: Foi decidido por tratamento conservador com prednisona, havendo significativa diminuição do volume testicular e normalização dos níveis de andrógenos. CONCLUSÃO: Este caso demonstra a importância de sempre se considerar a hipótese de HRA intratesticulares no diagnóstico diferencial dos tumores testiculares. A investigação e a conduta devem ser conduzidas de maneira cautelosa para se evitar orquiectomias desnecessárias.
OBJECTIVES: Testicular tumors are a rare condition associated with congenital adrenal hyperplasia (CAH), originated from intratesticular adrenal rest tumors, and they are rarely associated with malignant tumors. Their histological differentiation from Leydig-cell tumors is quite difficult, which would lead to inappropriate orchiectomies. Thus the objective of this report was to present this diagnostic dilemma. METHODS: Reported the case of 16-yr-old boy with previous diagnosis of CAH with bilateral testicular enlargement who was recommended to be submitted to a bilateral orchiectomy. RESULTS: Considering this findings, it was decided to treat conventionally with prednisone with significant reduction of testicular volume, and normalization of androgens levels. CONCLUSION: This case shows the importance of intratesticular adrenal rest tumors in the differential diagnosis of testicular tumors. Cautious approach during investigation and treatment are recommended to avoid inappropriate orchiectomies.
Subject(s)
Adolescent , Humans , Male , Adrenal Hyperplasia, Congenital/pathology , Adrenal Rest Tumor/pathology , Leydig Cell Tumor/pathology , Testicular Neoplasms/pathology , Antineoplastic Agents, Hormonal/therapeutic use , Diagnosis, Differential , Leydig Cell Tumor/drug therapy , Prednisone/therapeutic use , Testicular Neoplasms/drug therapyABSTRACT
Antecedentes: Los tumores de células de Leydig sonpoco frecuentes (3% de las neoplasias testiculares). Presentandos picos de incidencia, el 20% en niños y el 80% enadultos. Es bilateral en el 3% de los casos. Es frecuente asociarloa criptorquídia, atrofia testicular e infertilidad. Materialy métodos: Presentamos un estudio histopatológico,immunohistoquímico y clínico de siete casos de tumores decélulas de Leydig de testiculo diagnosticados en un periodode 9 años (1998-2007). Resultados: La edad de presentaciónclínica de nuestros casos fue variable: 22 a 67 años(media 35). Debutando como orquiepididimitis (2), hidrocele(2), infertilidad (1), ginecomastia bilateral (1) o Sindromeadrenogenital. La mayoria de los tumores estabanlocalizados en teste izquierdo (5/7). Los marcadores tumoralesen sangre fueron negativos aunque se detectaronimportantes alteraciones en los niveles hormonales sobretodo de la testosterona así como de los estrógenos y la progesterona.En TAC no se observaron lesiones metastásicasni adenomegalias. Como patologías importantes asociadasrelacionadas con su etiopatogenia están: Sd. adrenogenital(1), déficit cortical primario (por enf de Addison o hiperplasiacongénita adrenal) (1) y mielolipomas adrenales bilaterales(1). Histologicamente eran tumores muy semejantesexcepto uno que presentaba un patrón hipernefroide. Immunohistoquímicamenteexpresaron vimentina, inhibina ymelan A, apreciandose una expresión variable frente a marcadoresneuroectodérmicos; tampoco expresaron marcadoreshormonales. Conclusiones: El interés de estos casos esmostrar la complejidad de alteraciones clínicas asociadas aestos tumores, así como establecer un diagnóstico diferencialhistológico con otros tumores (AU)
Background: Leydig cell tumors are infrequent (3% oftestis neoplasms). There are two peaks of incidence: 20%developed in childhood and 80% in the adult life. They arebilateral in 3% of cases. Frequently they are associated tocryptorquidism, testicular atrophy and infertility. Materialand methods: We present a histopathologic, immunohistochemicaland clinical study of 7 cases of Leydig cell tumorof the testis diagnosed in a period of 9 years (1998-2007).Results: Age of presentation was variable: 22 to 67 years(mean 35). Clinically the presentation was orchyepididymitis(2), hydrocele (2), infertility (1), bilateral gynecomastia(1), and adrenogenital syndrome. The majority of tumorswere located in left testis (5/7); tumor markers were negative,although important alterations of hormonal levels (testosterone,estrogens and progesterone) were detected. TCscanner did not reveal metastatic deposits or adenomegalies.Pathologic diseases related to the tumors were: adrenogenitalsyndrome (1), primary adrenal cortical defect due toAddison disease or congenital adrenal hyperplasia (1) andbilateral adrenal myelolipoma (1). Histopathologically, thepattern was similar in all cases except one, that presenthypernefroid pattern. Immunohistochemically, the tumorsexpressed vimentin, inhibin and melan A, as well as a variableexpression of neuroectodermal markers. Hormonalreceptors were negative. Conclusions: The interest of thispaper is to show the complex pattern of clinical presentationof these tumors, and to establish the differential diagnosiswith other testicular tumors (AU)
Subject(s)
Humans , Adult , Middle Aged , Leydig Cell Tumor/pathology , Testicular Neoplasms/pathology , /blood , ImmunohistochemistryABSTRACT
Objetivos: Estudiar la incidencia y características de los tumores bilaterales de testículo. Material y métodos: Se realizó un estudio retrospectivo sobre una base de datos de tumores 98 testiculares tratados en nuestro servicio entre los años 1979 y 2004. Resultados. Se registraron 4 casos de tumores bilaterales (un 4,1%) en la serie. El intervalo de aparición del segundo tumor osciló entre 14 meses y 4 años y medio (siendo la mediana de 47 meses). En tres casos el tumor inicial fue un Carcinoma embrionario y en uno un tumor de Leydig. En dos casos el segundo tumor fue del mismo tipo histológico (Ca embrionario y tumor de Leydig), mientras que en los otros dos casos de Ca embrionario, el segundo tumor fue un seminoma y un teratocarcinoma. Respecto a la histología del primer tumor, se observó que sólo 3 de los 27 Ca embrionarios (11%) de nuestra serie, experimentaron una segunda neoplasia frente a 1 de los 2 tumores de Leydig (50%). Conclusiones. La incidencia de tumores bilaterales en nuestra serie fue del 4,1%, en nuestra serie el riesgo de aparición de un segundo tumor parece ser mas elevado en pacientes con tumores de Leydig aunque el pequeño número de caso no son permite extraer conclusiones significativas
Objectives: To study the incidence and characteristic of the bilateral tumours of testicle. Material and methods. It was carried out a retrospective study on a database of testiculars tumours 98 tried in our service among the years 1979 and 2004. Results. We registered 4 cases of bilateral tumours (4,1%) in the series. The interval of appearance of the second tumor oscillated between 14 months and 4 and a half years (being the medium of 47 months). In three cases the initial tumour was an embryonic Carcinoma and in one a tumour of Lydia. In two cases the second tumour was of the same type histological (embryonic Ca and tumour of Leydig), while in the other two cases of embryonic Ca, the second tumour was a seminoma and a teratocarcinoma. Regarding the histology of the first tumour, it was observed that only 3 of the 27 embryonic Ca (11%) of our series, they experienced a second neoplasia in front of 1 of the 2 tumours of Leydig (50%). Conclusions. The incidence of bilateral tumours in our series was of 4,1 %. In our series the risk of the second tumour seems to be higher in patients with Leyding tumours, therefore the lesser number of tumours do not allow us to know significantly conclusions
Subject(s)
Male , Humans , Germinoma/pathology , Testicular Neoplasms/pathology , Retrospective Studies , Seminoma/pathology , Teratocarcinoma/pathology , Leydig Cell Tumor/pathology , Recurrence , Testicular Neoplasms/epidemiologyABSTRACT
Se presenta el caso de un varón de 25 años de edad que presentó ginecomastia bilateral de dos meses de evolución. A la exploración clínica se observó la presencia de tumoración en testículo derecho. Se realiza orquiectomía, siendo el diagnóstico anatomopatológico de tumor de Leydig. Catorce meses después apareció otra masa en el testículo izquierdo, que tras su extirpación se comprobó que correspondía a otro tumor de Leydig. Se discute la incidencia, presentación clínica, diagnóstico y tratamiento de este tipo de neoplasia testicular. Se concluye que se trata de tumores raros (3% de los tumores testiculares) y cuya evolución es generalmente benigna, aunque no se puede descartar su malignización. La afectación bilateral ocurre en el 3% de estos tumores
No disponible
Subject(s)
Male , Adult , Humans , Gynecomastia/etiology , Leydig Cell Tumor/pathology , Testicular Neoplasms/complications , Orchiectomy , Testicular Neoplasms/pathologyABSTRACT
El tumor de células de Leydig de ovario es un tipo de neoplasia muy raro que suele presentarse en mujeres posmenopáusicas. Presentamos el caso de una mujer de 72 años que consultó por virilización. Las determinaciones hormonales mostraron una elevación muy marcada de la testosterona (12.038 pg/ml), con valores normales del resto de hormonas sexuales. En la ecografía se observó una tumoración de 10 mm en el ovario izquierdo. Se realizó histerectomía y doble anexectomía. El estudio histológico demostró la existencia de un tumor de células de Leydig en el ovario izquierdo. Tras la intervención, los valores plasmáticos de testosterona se normalizaron, y la paciente mostró una lenta regresión de los síntomas clínicos
Leydig cell tumor of the ovary is a very rare neoplasm that usually occurs in postmenopausal women. We report the case of a 72-year-old woman with symptoms of virilization. Hormonal evaluation showed marked elevation of serum testosterone (12038 pg/ml) and no evidence of increased production of other sexual hormones. Ultrasound examination revealed a 10-mm tumor within the left ovary. Subsequently, total hysterectomy with bilateral oophorectomy was performed. Histopathological examination showed a Leydig cell tumor within the left ovary. Postoperative plasma testosterone levels returned to normal and the patient showed slow regression of clinical symptoms
Subject(s)
Female , Aged , Humans , Leydig Cell Tumor/complications , Virilism/etiology , Ovarian Neoplasms/complications , Leydig Cell Tumor/pathology , Postmenopause , Virilism/pathology , Testosterone/analysis , Ovarian Neoplasms/pathologyABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Middle Aged , Testicular Neoplasms/pathology , Leydig Cell Tumor/pathology , Chorionic Gonadotropin/analysis , Tomography, X-Ray ComputedABSTRACT
La aparición de hirsutismo clínico en mujer menopáusica, de manera brusca y con poco tiempo de evolución, junto con otros factores, como hipertensión arterial, diabetes mellitus, poliglobulia, tiene que hacer pensar en un exceso de andrógenos, exógeno o endógeno. Presentamos un caso de virilización en una mujer menopáusica por un tumor de células del Leydig, secretor de andrógenos. Se trata de una neoplasia muy infrecuente, menos del 1% de los tumores ováricos y de presentación muy rara en la menopausia (AU)
The sudden development of clinical hirsutism in a post-menopausal woman, with little time since onset, along with other factors such as arterial hypertension, diabetes mellitus, and polycythemia, should lead to suspicion of an excess of androgens, whether exogenous or endogenous. We present a case of virilization in a post-menopausal woman due to androgenic secretion from a hilus cell (Leydig) ovarian tumor. This tumor is highly infrequent, accounting for less than 1% of ovarian tumors, and rarely develops during menopause (AU)
Subject(s)
Female , Middle Aged , Humans , Leydig Cell Tumor/pathology , Ovarian Neoplasms/pathology , Postmenopause , Hirsutism/etiology , Hypertension/complications , Diabetes Mellitus/complications , AndrogensABSTRACT
Introducción: Los tumores de los cordones sexuales y del estroma corresponden al 5 por ciento de los tumores ováricos. La variedad a células de Leydig es relativamente rara y se han descrito pocos casos en la bibliografía. Sin embargo, es uno de los diagnósticos que se debe considerar en todas las pacientes posmenopáusicas con signos de virilización. Caso clínico: Paciente de 56 años, posmenopáusica, con un cáncer de mama, que acude a la consulta oncológica, donde se evidencia, en el examen físico, hirsutismo y otros elementos de virilización. Se aprecia elevación marcada de la testosteronemia y otros andrógenos. En la ecografía transvaginal y la tomografía computarizada de abdomen-pelvis se observa una tumoración anexial derecha sólida. Se realiza histerectomía total más anexectomía bilateral más apendicectomía y omentectomía. En la anatomía patológica se evidencia un tumor de células de Leydig de variedad hiliar del ovario. Discusión: Los signos de virilización en mujeres posmenopáusicas obedecen con más frecuencia a trastornos de la función ovárica que adrenal. En el caso clínico presentado se diagnosticó un tumor de células de Leydig de variedad hiliar, que se confirmó por la presencia característica de cristales de Reinke. El tratamiento es quirúrgico, y se recomienda la ooforectomía bilateral (AU)
Subject(s)
Female , Middle Aged , Humans , Virilism/etiology , Leydig Cell Tumor/pathology , Ovarian Neoplasms/complications , Hirsutism/etiology , Postmenopause , Testosterone/blood , Ovariectomy , Ovarian Neoplasms/surgeryABSTRACT
Se presenta un caso de tumor de células de Leydig, hallazgo no frecuente entre los tumores del testículo destacando aspectos clínicos, histopatológicos criterios diagnósticos y de tratamiento
Subject(s)
Humans , Male , Adult , Inhibins , Biomarkers, Tumor , Testicular Neoplasms , Leydig Cell Tumor/diagnosis , Erectile Dysfunction , Gynecomastia , Oligospermia , Puberty, Precocious , Leydig Cell Tumor/pathologyABSTRACT
Se presenta un caso de tumor de células de Leydig, hallazgo no frecuente entre los tumores del testículo destacando aspectos clínicos, histopatológicos criterios diagnósticos y de tratamiento (AU)
Subject(s)
Humans , Male , Adult , Leydig Cell Tumor/diagnosis , Testicular Neoplasms , Biomarkers, Tumor , Inhibins/diagnosis , Leydig Cell Tumor/pathology , Erectile Dysfunction/etiology , Puberty, Precocious/etiology , Gynecomastia/etiology , Oligospermia/etiologyABSTRACT
Se presenta un caso de leydigioma iagnosticado luego de cirugía por ginecomastia bilateral sucesiva asociado con quiste epididimario durante el seguimiento de tumor renal de células claras (incidentaloma) nefrectomizado 3 años antes