Multiple testicular leydig cell tumors presenting with azoospermia:A case report and literature review
10.13263/j.cnki.nja.2025.11.008
- VernacularTitle:以无精子症为表现的多发睾丸间质细胞瘤1例报告并文献复习
- Author:
Qing LIU
1
;
Zhisheng HU
1
;
Yong YAO
1
;
Kaijie XU
1
;
Huiling WU
1
Author Information
1. 金华市人民医院泌尿外科,浙江金华 321000
- Publication Type:Journal Article
- Keywords:
testicular Leydig cell tumor;
diagnosis;
therapy;
azoospermia;
Leydig cell tumor
- From:
National Journal of Andrology
2025;31(11):1009-1013
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis and treatment of multiple testicular Leydig cell tumors presenting with azoospermia.Methods Clinical data of a case of multiple testicular Leydig cell tumors presenting with azoospermia as well as re-lated article were reviewed.Results The patient visited the doctor due to"failure to conceive after 3 years of regular unprotect-ed sexual intercourse",and two consecutive semen analyses both indicated azoospermia.Testicular color Doppler ultrasound,en-hanced CT and pelvic MRI all suggested testicular space-occupying lesions.Preoperative evaluation suggested benign testicular tumors.Intraoperative frozen section pathology confirmed Leydig cell tumors.Microscopic testis-sparing tumor enucleation and microsurgical testicular sperm extraction(mTESE)were performed,with no sperm identified intraoperatively.The patient under-went successful tumor resection without complications.During the 12-month follow-up period,no tumor recurrence or metastasis was observed.Seminal volume increased compared to pre-operative levels,but azoospermia persisted.Conclusions Testicular Leydig cell tumor is a rare neoplasms originating from the gonadal stroma.Preoperative diagnosis is difficult.Radical orchiectomy is the primary treatment modality.However,testis-sparing tumor enucleation may be a safe and effective alternative for patients with bilateral testicular tumors.Tumor enucleation with testicular preservation is also a safe and effective choice for the patients with small-sized lesions or prepubertal status,whereas a long-term close follow-up is strictly implemented.
