Leydig cell tumour of the testis
A Leydig cell tumour 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.
1-3% of all testicular tumours, but the most common sex-cord stromal tumour. Tend to be bimodal, with one peak occurring in paediatric patients (5-10 years) and one in adults (20-30 years). Malignancy occurs in ~10% of tumours.
Leydig cell tumours arise from the interstitial cells of Leydig adjacent to the seminiferous tubules.
Leydig cell tumours of the testis may present with serum hormonal imbalance (~30%). Virilization (including precocious puberty) may occur. Hyperestrogenism may also occur and patients may demonstrate gynaecomastia.
Malignancy cannot be excluded on imaging.
- small, hypoechoic, round intratesticular mass
- may demonstrate cystic areas
- difficult to differentiate from other testicular tumours
On an imaging differential, consider:
Ultrasound - testicular and scrotal
- ultrasound (introduction)
testicular and scrotal ultrasound
unilateral testicular lesion
- testicular torsion
- testicular rupture
- germ cell tumours of the testis
- sex cord / stromal tumours of the testis
- bilateral testicular lesion
- paratesticular lesions
- tubular ectasia of the rete testis
- cystadenoma of the rete testis
- testicular sarcoidosis
- testicular tuberculosis
- spermatic cord
- fibrous pseudotumour of the scrotum
- scrotal leiomyosarcoma
- testicular adrenal rest tumours (TARTs)
- tunica vaginalis testis mesothelioma
- splenogonadal fusion
- unilateral testicular lesion
- 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