De Jong Z, Pontonnier F, Plante P, Bennet A, Escourrou G, Mansat A
Clinique Urologique, CHU Rangueil, Toulouse.
J Urol (Paris). 1988;94(4):217-21.
The authors report one case of a bilateral testicular Leydig cell tumor in a man of 29 years old. There are few cases of such tumors reported in the literature. Gynecomastia force the patient to consult his doctor. His hormonal profile is practically normal; however, the serum estradiol is at the limit superior of normal range, and serum testosterone at the limit inferior. Testicular palpation is normal. It is the scrotal ultrasonography which confirms the diagnosis of testicular tumor. The scrotal ultrasonography has to be performed in every patient with unexplained gynecomastia. There is no metastasis. Before the treatment, the sperm conservation is performed (his sperm is normal). Our surgical sequence for this man without children was the next one: 1. inguinal orchiectomy was performed at the side of bigger tumor. Histological diagnosis was the benign Leydig cell tumor; 2. one month later, an inguinal orchidotomy at the other side was performed and the tumor palpable of 9 mm was removed. The extemporaneous biopsy confirmed the same diagnosis as at the other side; 3. one year later, there is no metastasis and the woman of our patient becomes pregnant.
作者报告了一例29岁男性双侧睾丸间质细胞瘤。文献中报道的此类肿瘤病例很少。男性乳房发育促使患者就医。其激素水平基本正常;然而,血清雌二醇处于正常范围上限,血清睾酮处于下限。睾丸触诊正常。是阴囊超声检查确诊了睾丸肿瘤。对于每例不明原因男性乳房发育的患者都应进行阴囊超声检查。无转移。治疗前,进行了精子保存(其精子正常)。对于这名无子女的男性,我们的手术步骤如下:1. 在肿瘤较大一侧进行腹股沟睾丸切除术。组织学诊断为良性间质细胞瘤;2. 一个月后,在另一侧进行腹股沟睾丸切开术,切除可触及的9毫米肿瘤。术中活检确诊与另一侧相同;3. 一年后,无转移,患者的妻子怀孕。