Testis sparing surgery for Leydig cell tumors: New three cases and review of the current literature

Abstract

Introduction: Leydig cells tumors of the testis are uncommon, representing between 1 and 3% of the testicular tumors and for which the natural history and therapy are debated between radical orchitectomy and organ-sparing surgery. Subjects and methods: We report three new cases of Leydig cells tumors, treated in our department and we discuss the clinical, diagnostic and therapeutic aspects of this uncommon tumor. Results: The mean patient age was 29 years (23–37 years). Medical referral was for a testicular pain in two and gynecomastia in one case. All patients were treated surgically, through an inguinal incision and the procedure included clamping of the spermatic cord. During surgery, frozen section were analyzed in two cases and the tumor enucleation with organ-sparing surgery was performed. The other patient had an unilateral orchidectomy and controlateral tumorectomy. The mean follow-up was 40 months with no local recurrence. Conclusion: Patients diagnosed with Leydig cells tumors have a good prognosis; this study shows the safety of conservative surgery treatment, provided it is subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually have a favorable prognosis.

Keywords

• Leydig cell tumor
• Organ-sparing surgery
• Radical orchitectomy