Multiple testicular leydig cell tumors presenting with azoospermia:A case report and literature review
LIU Qing
HU Zhisheng
YAO Yong
XU Kaijie
WU Huiling
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.
Keywords：testicular Leydig cell tumordiagnosistherapyazoospermiaLeydig cell tumor
Publication Date：2025-11-20
Online Publishing Date：2025-12-18(First online date of this platform, not the publication date of the document)
Pages：5( 1009-1013 )