Clinical cases

Leydig cell tumor US finding in older male

Results

The conventional US showed a voluminous left epididymis cyst (52 x 34,5 x 23,7 mm) (fig.1) and in the right normally sized testis a small hypoechoic solid lesion (4,5 x 4,6 mm) near to the epididymis head (fig. 2-3).

The color-Doppler and power-Doppler US reveal an increased perilesional and minimal intralesional vascularity (fig. 4).

Normal level of α-fetoprotein serum (3,0 ng/ml) and β-HCG absent. The subsequent right orchifuniculectomy was carried out following an ultrasound guided needle biopsy and an extempore histological positive analysis from solid neoplasm.
At the histopathological examination a minimal nodule with cellular findings of benign Leydig cell tumor is found.

Figure 1 - Conventional US, longitudinal sonogram of the left testis: a large cyst in the head of the epididymis is observed (mm 52 x 34,5 x 23,7 maximum diameters).
Figure 1 - Conventional US, longitudinal sonogram of the left testis: a large cyst in the head of the epididymis is observed (mm 52 x 34,5 x 23,7 maximum diameters).

Figure 2 - Conventional US, longitudinal sonogram of the right testis: hypoechoic solid focal lesion (mm 4,5 x 4,6 maximum diameters) in the right testis closed to the cephalic portion of the epididymis is evident.
Figure 2 - Conventional US, longitudinal sonogram of the right testis: hypoechoic solid focal lesion (mm 4,5 x 4,6 maximum diameters) in the right testis closed to the cephalic portion of the epididymis is evident.

Figure 3 - Color-Doppler US, transversal sonogram of the right testis: perilesional micro vessels are shown.
Figure 3 - Color-Doppler US, transversal sonogram of the right testis: perilesional micro vessels are shown.

Figure 4 - Histological specimen: minimal nodule with cellular findings of benign Leydig cell tumor.
Figure 4 - Histological specimen: minimal nodule with cellular findings of benign Leydig cell tumor.