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Prasivoravong J, Barbotin AL, Derveaux A, Leroy C, Leroy X, Puech P, Mitchell V, Marcelli F, Rigot JM. Leydig cell tumor of the testis with azoospermia and elevated delta4 androstenedione: case report. Basic Clin Androl 2016; 26:14. [PMID: 27833751 PMCID: PMC5100078 DOI: 10.1186/s12610-016-0041-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/14/2016] [Indexed: 12/27/2022] Open
Abstract
Background Secreting interstitial cell (Leydig cell) tumors are rare. In adults, the clinical picture and steroid levels are variable. Case presentation This paper presents a case of left testicular tumor, showing azoospermia with normal serum level of total testosterone, collapsed FSH and LH, and high delta4 androstenedione. Histopathological investigation revealed a Leydig cell tumor. TESE allowed spermatozoa extraction and freezing. Testicular histology found hypospermatogenesis and germ-cell aplasia with interstitial fibrosis. Surgical resection of the tumor resulted in normalization of gonadotropins and fall in serum delta4 androstenedione to subnormal levels in the postoperative period confirming that the tumor was secreting delta4 androstenedione. It was hypothesized that high delta4 androstenedione resulted in intra tumoral 17 β-HSD overtaken by delta4 androstenedione or that 17 β-HSD activity in the tumor was different from that of normal Leydig cells. Three months after surgery sperm analysis found a complete recovery of spermatogenesis. A spontaneous pregnancy occurred 3 months after surgery and a girl was born. Conclusions In this case, the diagnosis of testicular Leydig cell tumor secreting delta4 androstenedione was made in a context of azoospermia.
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Affiliation(s)
- J Prasivoravong
- Department of Andrology, Lille University Hospital, Lille, France ; Department of Andrology, CHRU Lille, Hôpital Calmette, Boulevard du Professeur Leclercq, 59037 Lille Cedex, France
| | - A-L Barbotin
- Biology of Reproduction Unit, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
| | - A Derveaux
- Department of Andrology, Lille University Hospital, Lille, France
| | - C Leroy
- Department of Andrology, Lille University Hospital, Lille, France
| | - X Leroy
- Department of Pathology, Lille University Hospital, Lille, France
| | - P Puech
- Department of Radiology, Lille University Hospital, Lille, France
| | - V Mitchell
- Biology of Reproduction Unit, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
| | - F Marcelli
- Department of Andrology, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
| | - J-M Rigot
- Department of Andrology, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
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