Fertility before and after treatment of the patient with Leydig cell tumor – case report

Even though Leydig cell tumor (LCT) represents the most common neoplasia among testicular sex cord-stromal tumors (SCSTs), it is a rare condition, comprising 1-2% of all testicular tumors, with a 10% risk of malignancy most commonly located in retroperitoneal lymph nodes. LCTs may demonstrate various clinical manifestations - from asymptomatic intratesticular swelling through nonspecific symptoms such as loss of libido, impotence or infertility, up to feminizing or virilizing syndromes due to hormonal activity of the tumor. This article presents a case of Leydig cell tumor that was associated with azoospermia what have rarely been reported worldwide. A 27-year-old male presented to the urologist with one-month history of palpable testicular mass. Imaging tests revealed a well demarcated solid focal lesion in the upper pole of the left testicle and semen analysis indicated azoospermia. Due to small testicular lesion, negative serum markers and negative reports for malignancy in MRI imaging, testis-sparing surgery (TSS) was performed. The final histopathological examination revealed a Leydig cells tumor positive for inhibin, calretinin and MelanA. Six months after the surgery spermatogenic function was partially restored what have rarely been reported in scientific papers. This case indicates that TSS may provide an effective way of semen quality improvement, although further research is required.