Clinical cases

Leydig cell tumor US finding in older male

Introduction

Gonadal stromal tumors represent about 4% of all intra-scrotal neoplasms; they are often incidentally found in US exam due to their prevailing small size. Among those the Leydig cell tumors are the most frequent in pediatric patients; while it rarely occurs in males over 60 years (1% of all gonadal neoplasms).

A scrotal enlargement is present in 40% approximately of the cases, while in 20-30% a gynecomastia and a libido loss are revealed. These last symptoms can be preceded by or associated with the appearance of a testicular mass which represents the first tumor’s sign. This tumor is benign in 90% of the pediatric patients.

The malignant forms are generally discovered in elder men presenting a scrotal mass with no hormonal changes [1-7]. We describe a small and rare benign Leydig cell tumor found incidentally in an old man.

Materials and methods

A 73-years man, with an intra-scrotal left mass and no endocrine signs underwent conventional ultrasonography of the testis using a 512 Sequoia Imagegate equipment (Acuson-Siemens) with high frequency linear small parts probe (10-14 MHz) and “chirp” coded excitation and frequency compound technology.

Color Doppler examination was carried out using 8-14 MHz frequency, the wall filter and PRF value as low as possible to detect the lowest flow avoiding the generation of movement artifacts