Leydig-cell tumor of the testis with gynecomastia and elevated estrogen levels.
A case report of a Leydig-cell tumor of the testis in a 24-year-old male patient with gynecomastia but no other evidence of feminization is presented. Genitalia were reported to be normal at 1st examination. 4 months later, a 2cm nontender mass was felt in the right testis. A right radical orchidectomy was performed. The tumor was reported to be a Leydig-cell neoplasm without evidence of invasion of adjacent tissues of metastases. The gynecomastia was resolved within 3 months after surgery. No recurrence of the tumor has occurred after 10 months. Serum and urine tests for human chorionic gonadotropin were negative. Prior to orchidectomy, serum estradiol was elevated and serum testosterone depressed. Postoperatively these values became normal. Reinke crystalloids were found in tumor tissue. Photographic reproductions illustrate histologic findings. After surgical removal of a Leydig-cell tumor an estradiol increase in serum may signal recurrence. It is recommended that all endocrine, nutritional, neoplastic, chromosomal, and drug etiologies of gynecomastia be investigated before surgical resection of the enlarged breasts.