Leydig cell tumor of the testis
Last revised by Zentout Sofiane on 23 Mar 2023
Citation, DOI, disclosures and article data
Citation:
Morgan M, Sofiane Z, Yap J, et al. Leydig cell tumor of the testis. Reference article, Radiopaedia.org (Accessed on 20 Apr 2024) https://doi.org/10.53347/rID-32723
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rID:
32723
Article created:
11 Dec 2014,
Matt A. Morgan ◉
Disclosures:
At the time the article was created Matt A. Morgan had no recorded disclosures.
View Matt A. Morgan's current disclosures
Last revised:
23 Mar 2023,
Zentout Sofiane
Disclosures:
At the time the article was last revised Zentout Sofiane had no financial relationships to ineligible companies to disclose.
View Zentout Sofiane's current disclosures
Revisions:
12 times, by
8 contributors -
see full revision history and disclosures
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Synonyms:
- Leydig cell tumor (testes)
- Leydig cell tumours of the testis
- Leydig cell tumour (testes)
- Leydig cell tumor of the testis
A Leydig cell tumor of the testis is an uncommon testicular neoplasm. Its imaging appearance on ultrasound and MRI is nonspecific, but clinically it is associated with serum hormonal imbalance.
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Epidemiology
1-3% of all testicular tumors, but the most common sex-cord stromal tumor. Tend to be bimodal, with one peak occurring in pediatric patients (5-10 years) and one in adults (20-30 years). Malignancy occurs in ~10% of tumors.
Pathology
Leydig cell tumors arise from the interstitial cells of Leydig adjacent to the seminiferous tubules. They are characterized by the presence of intracytoplasmic Reinke crystals 3.
Clinical presentation
Leydig cell tumors of the testis may present with serum hormonal imbalance (~30%). Virilization (including precocious puberty) may occur. Hyperestrogenism may also occur and patients may demonstrate gynecomastia.
Radiographic features
Malignancy cannot be excluded on imaging.
Ultrasound
- small, hypoechoic, round intratesticular mass
- may demonstrate cystic areas
- most often unilateral
- difficult to differentiate from other testicular tumors
Differential diagnosis
On an imaging differential, consider:
- seminoma: much more common
- non-seminomatous germ cell tumor
- focal testicular hematoma
- (lymphoma): usually in older men (>60) and often bilateral
References
- 1. Woodward PJ, Sohaey R, O'Donoghue MJ et-al. From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 2002;22 (1): 189-216. doi:10.1148/radiographics.22.1.g02ja14189 - Pubmed citation
- 2. Kim I, Young RH, Scully RE. Leydig cell tumors of the testis. A clinicopathological analysis of 40 cases and review of the literature. Am. J. Surg. Pathol. 1985;9 (3): 177-92. Pubmed citation
- 3. Planinić A, Marić T, Bojanac A, Ježek D. Reinke Crystals: Hallmarks of Adult Leydig Cells in Humans. Andrology. 2022. doi:10.1111/andr.13201 - Pubmed
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