Presentation
Bilateral testicular pain.
Patient Data
Small hypoechoic nodule in the mid portion of the right testis. Some internal vascularity detected on colour Doppler images. Findings are consistent with testicular neoplasm.
There is a hypoechogenic avascular area with irregular borders extending vertically through the mid portion of the right testis, consistent with surgical scar.
Case Discussion
This is a case of benign Leydig cell tumour diagnosed 4 years ago. The patient underwent a partial orchidectomy and he has been followed since then, and the above ultrasound follow-up study is the latest one.
All of tumour work-up (tumour markers and CT torso, bone scan) at the time of diagnosis came back negative. Because of that; in addition to the young age of the patient, small size of the nodule and most importantly the frozen pathology result at the time of the surgery that revealed that the tumour most likely to be benign, the urology team had decided to perform partial orchidectomy.
Summary of the pathology report:
Diagnosis: Benign Leydig cell tumour.
Tumour size: 0.5 cm
Margins: Non-infiltrative
Necrosis: Absent.
Nuclear atypia: Minimal to Mild
Mitosis: Approximately Five per 10 HPF
MIB-1 activity: Approximately 4-5 %
Lymphatic and vascular invasion: not seen.