Loss of libido in a man with an incidental Leydig cell tumour of the testis: a rare tumour discovered following an isolated common complaint

Dominic Brown; Georgios Tsampoukas

doi:10.1093/jscr/rjaa241

Loss of libido in a man with an incidental Leydig cell tumour of the testis: a rare tumour discovered following an isolated common complaint

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa241 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Dominic Brown ◽

Georgios Tsampoukas

Keyword(s):

Testicular Cancer ◽

Leydig Cell ◽

Biochemical Markers ◽

Hormonal Activity ◽

Rare Tumour ◽

Common Complaint ◽

Leydig Cell Tumour ◽

Loss Of Libido ◽

High Index Of Suspicion ◽

Leydig Cell Tumours

Abstract Leydig cell tumours (LCTs) are rare testicular stromal neoplasms classically presenting with a painless testicular mass or swelling in adults. Symptoms secondary to hypogonadism may occur resulting from the hormonal activity of these tumours. Loss of libido is described in LCTs in conjunction with other symptoms; however, no case has reported this as the sole presenting feature. We describe the case of a 42-year-old man presenting to his General Practitioner with loss of libido and no other features suspicious of testicular cancer. Ultrasound performed due to an unrelated epididymal cyst detected an incidental mass confirmed as a benign LCT following radical orchidectomy. Biochemical markers remained normal throughout and following treatment his libido returned to normal. This case may serve as a reminder for clinicians to maintain a high index of suspicion for testicular neoplasms in patients with features of hypogonadism in the absence of classical features for testicular cancer.

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817 Loss of Libido in A Man with An Incidental Leydig Cell Tumour Of the Testis: A Rare Tumour Discovered Following an Isolated Common Complaint

British Journal of Surgery ◽

10.1093/bjs/znab259.325 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

D Brown ◽

G Tsampoukas

Keyword(s):

Testicular Cancer ◽

Leydig Cell ◽

Biochemical Markers ◽

Hormonal Activity ◽

Rare Tumour ◽

Common Complaint ◽

Leydig Cell Tumour ◽

Loss Of Libido ◽

High Index Of Suspicion ◽

Leydig Cell Tumours

Abstract Introduction Leydig cell tumours (LCTs) are rare testicular stromal neoplasms classically presenting with a painless testicular mass or swelling in adults. Symptoms secondary to hypogonadism may occur resulting from the hormonal activity of these tumours. Loss of libido is described in LCTs in conjunction with other symptoms; however, no case has reported this as the sole presenting feature. Case report We describe the case of a 42-year-old man presenting to his General Practitioner with loss of libido and no other features suspicious of testicular cancer. Ultrasound performed due to an unrelated epididymal cyst detected an incidental mass confirmed as a benign LCT following radical orchidectomy. Biochemical markers remained normal throughout and following treatment his libido returned to normal. Conclusions This case may serve as a reminder for clinicians to maintain a high index of suspicion for testicular neoplasms in patients with features of hypogonadism in the absence of classical features for testicular cancer.

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Sertoli-Leydig Cell Tumour and DICER1 Mutation: A Case Report and Review of the Literature

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/7927362 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

B. Wormald ◽

S. Elorbany ◽

H. Hanson ◽

J. W. Williams ◽

S. Heenan ◽

...

Keyword(s):

Case Report ◽

Gene Mutation ◽

Leydig Cell ◽

Autosomal Dominant ◽

Review Of The Literature ◽

Autosomal Dominant Fashion ◽

Rare Tumours ◽

Leydig Cell Tumour ◽

Underlying Pathology ◽

Leydig Cell Tumours

Sertoli-Leydig cell tumours of the ovary (SLCT) are rare tumours predominantly caused by mutations in the DICER1 gene. We present a patient with a unilateral SLCT who had an underlying germline DICER1 gene mutation. We discuss the underlying pathology, risks, and screening opportunities available to those with a mutation in this gene as SLCT is only one of a multitude of other tumours encompassing DICER1 syndrome. The condition is inherited in an autosomal dominant fashion. As such, genetic counselling is a key component of the management of women with SLCT.

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Hyperandrogenism caused by ovarian Leydig cell tumour: finding the needle in a haystack

BMJ Case Reports ◽

10.1136/bcr-2020-238012 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238012

Author(s):

Chin Voon Tong ◽

Yong Ting Tai

Keyword(s):

Leydig Cell ◽

Specific Treatment ◽

Cell Tumour ◽

Imaging Modalities ◽

Surgical Removal ◽

Venous Sampling ◽

Ovarian Tumours ◽

Potentially Malignant ◽

Leydig Cell Tumour ◽

Leydig Cell Tumours

Leydig cell tumours (LCTs) of the ovary are rare ovarian tumours that usually present with hyperandrogenism. Conventional radiological imagings are helpful in localising these tumours. However, some tumours may be too small to be localised before curative surgical removal. It is important to identify these androgen-secreting neoplasms which originate mostly from adrenals or ovaries because they are potentially malignant and require specific treatment. When conventional imagings are unrevealing, selective ovarian and adrenal venous sampling (SOAVS) is the next option. We report a case of LCT that was localised by SOAVS after results from other imaging modalities remained inconclusive.

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Atypical presentation of Leydig cell tumour in three prepubertal patients: diagnosis, treatment and outcomes

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0467 ◽

2019 ◽

Vol 32 (4) ◽

pp. 369-374 ◽

Cited By ~ 2

Author(s):

Miriam García González ◽

Isabel Casal-Beloy ◽

Iván Somoza Argibay ◽

Teresa Dargallo Carbonell

Keyword(s):

Leydig Cell ◽

Tumour Size ◽

Atypical Presentation ◽

Key Factors ◽

Precocious Pseudopuberty ◽

Leydig Cell Tumour ◽

Prepubertal Boys ◽

Hormonal Action ◽

Leydig Cell Tumours

Abstract Background Testicular tumours are uncommon in children, accounting for only 1% of all childhood tumours. Prepubertal Leydig cell tumours actively secrete testosterone and as a result, patients typically present with isosexual precocious pseudopuberty, this being the first cause of consultation. We present three cases of Leydig cell tumours in prepubertal patients with an atypical presentation. Methods We studied three cases of Leydig cell tumours in prepubertal boys, who either consulted for testicular asymmetry or were incidentally found to have the tumour in the absence of systemic signs of systemic hyperandrogenism or precocious puberty. In all cases, a well-circumscribed testicular mass was found by testicular ultrasound. The diagnosis was confirmed by histology. In all three cases, testicular enucleation was performed with satisfactory follow-up. Results Following the surgical procedure, during the follow-up, all patients showed a normal testicular volume in comparison with the contralateral testis. No complications were seen during follow-up. Conclusions A testicular ultrasound in children developing asymptomatic testicular asymmetry might be recommended due to its possible hormonal action locally. An early testicular ultrasound, testicular swelling discrepancies, tumour size and androgen production are key factors in the prognosis and management of this type of tumour.

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Ageing, testicular tumours and the pituitary-testis axis in dogs

Journal of Endocrinology ◽

10.1677/joe.0.1660153 ◽

2000 ◽

Vol 166 (1) ◽

pp. 153-161 ◽

Cited By ~ 38

Author(s):

MA Peters ◽

FH de Jong ◽

KJ Teerds ◽

DG de Rooij ◽

SJ Dieleman ◽

...

Keyword(s):

Sertoli Cell ◽

Leydig Cell ◽

Venous Blood ◽

Cell Tumour ◽

Age Related ◽

Sertoli Cell Tumour ◽

Leydig Cell Tumour ◽

Sertoli Cell Tumours ◽

Leydig Cell Tumours ◽

Age Related Changes

Dogs of different ages without testicular diseases were evaluated to study possible age-related changes in hormone concentrations in serum. Dogs with testicular tumours were also investigated to study the relation between tumour type and hormone concentrations; in this study, dogs with Sertoli cell tumours, Leydig cell tumours and seminomas were included. We measured testosterone, oestradiol, LH, FSH and inhibin-like immunoreactivity concentrations in peripheral venous and testicular venous blood of these animals. In normal dogs there appeared to be no age-related changes in the concentrations of the investigated hormones, except for a significant age-related decrease in oestradiol concentrations in testicular venous blood (P<0.02). Dogs with a Sertoli cell tumour had greater oestradiol concentrations and inhibin-like immunoreactivity in both peripheral and testicular venous blood than did dogs without a neoplasm (P<0. 05). Testosterone concentrations were reduced in dogs with Sertoli cell tumours, as were FSH and LH. Feminisation occurred in eight of 13 dogs with a Sertoli cell tumour and in two of 14 dogs with a Leydig cell tumour; it was accompanied by a significantly greater oestradiol concentration than in normal dogs and in dogs with Sertoli cell tumours without signs of feminisation. Dogs with a Leydig cell tumour had greater concentrations of oestradiol and inhibin-like immunoreactivity in both peripheral venous and testicular venous blood than did dogs without a neoplasm (P<0.05). The testosterone concentration in testicular venous blood of these dogs was lower than that in dogs with normal testes. The concentration of LH in peripheral venous blood was also reduced (P<0. 05). Hormone concentrations in dogs with a seminoma were not different from those in normal dogs. It was concluded that seminomas are not endocrinologically active. In contrast, both Sertoli cell tumours and Leydig cell tumours can cause increased oestrogen production leading to signs of feminisation. These tumours also have considerable amounts of inhibin-like immunoreactivity, but only in Sertoli cell tumours does this result in a reduction in FSH concentrations, suggesting that Sertoli cell tumours secrete dimeric inhibin, whereas Leydig cell tumours presumably produce loose alpha-subunits that cross-react in the inhibin assay but are not biologically active.

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NEW VIEWS ON THE HORMONE-PRODUCING MESENCHYMOMAS OF THE OVARIES

Acta Endocrinologica ◽

10.1530/acta.0.xxxv0513 ◽

1960 ◽

Vol XXXV (IV) ◽

pp. 513-517

Author(s):

W. P. Plate

Keyword(s):

Granulosa Cell ◽

Sertoli Cell ◽

Leydig Cell ◽

Cell Tumour ◽

Theca Cell ◽

Granulosa Cell Tumour ◽

Sertoli Cell Tumours ◽

Leydig Cell Tumours

ABSTRACT The hormone-producing mesenchymomas of the ovaries can be divided into androblastomas and gynaecoblastomas. The former are derived from »male« elements, and consist of Sertoli-cell tumours and Leydig-cell tumours. The latter arise from »female« elements and consist of granulosacell tumours and theca-cell tumours. Sertoli-cell tumours and granulosacell tumours produce oestrogens, while Leydig-cell tumours and theca-cell tumours produce oestrogens or androgens. Histologically, androblastomas and gynaecoblastomas are often difficult to distinguish. Since no »female« elements occur in a testicle, a granulosa-cell tumour in a testicle is improbable. Gynandroblastomas, therefore, can only be found in an ovary.

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Female hyperandrogenemia, Think beyond the common: A rare case of ovarian Sertoli-Leydig cell tumour

Endocrine Abstracts ◽

10.1530/endoabs.65.p386 ◽

2019 ◽

Author(s):

Ziad Hussein ◽

Yulia Manova ◽

Stephanie Baldeweg

Keyword(s):

Leydig Cell ◽

Rare Case ◽

Cell Tumour ◽

Leydig Cell Tumour ◽

The Common

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Spermatogenesis and testicular tumours in ageing dogs

Reproduction ◽

10.1530/reprod/120.2.443 ◽

2000 ◽

pp. 443-452 ◽

Cited By ~ 20

Author(s):

MA Peters ◽

DG de Rooij ◽

KJ Teerds ◽

I van Der Gaag ◽

FJ van Sluijs

Keyword(s):

Sertoli Cell ◽

Leydig Cell ◽

Seminiferous Tubules ◽

Score System ◽

Testicular Tumours ◽

Severe Impairment ◽

Per Se ◽

Testicular Disease ◽

Sertoli Cell Tumours ◽

Leydig Cell Tumours

Spermatogenesis was examined in testes from 74 dogs of various breeds without clinically detected testicular disease. A modified Johnsen score system was used to determine whether spermatogenesis deteriorates with ageing. The diameter of seminiferous tubules was measured in dogs without testicular disease to examine other possible effects of ageing on tubular performance. There appeared to be no relation between age and these variables. The influence of testicular tumours on spermatogenesis was also investigated in both affected and unaffected testes. The testes of 28 dogs with clinically palpable tumours and 21 dogs with clinically non-palpable tumours were investigated. In cases of unilateral occurrence of a tumour, impairment of spermatogenesis was observed only in the affected testis of dogs with clinically detected tumours. Bilateral occurrence of tumours, whether detected clinically or non-clinically, was associated with severe impairment of spermatogenesis. The prevalence of tumours increased during ageing. Eighty-six per cent of the clinically detected and 57% of the non-clinically detected tumours were found in old dogs. Multiple types of tumour and bilateral occurrence were very common. Seminomas and Leydig cell tumours were more frequent than Sertoli cell tumours. It was concluded that spermatogenesis per se did not decrease during ageing in dogs but the occurrence of testicular tumours increased with ageing and affected spermatogenesis significantly, as reflected by a lower Johnsen score.

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