Kong Qingkuo, Yu Yang, Tian Tian, Zhang Hongguo, Sun Meiling, Liu Ruizhi, Liu Yanhong
Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, Jilin 130021, PR China.
Medicine (Baltimore). 2020 Sep 4;99(36):e22085. doi: 10.1097/MD.0000000000022085.
Testicular tumors represent 1% to 1.5% of all tumors in men. Those derived from Leydig cells are rare and account for 1% of testicular tumors. Leydig tumor cells can produce steroid hormones such as estrogen, progesterone and testosterone. The amount and type of hormones secreted by these tumors may produce complicated clinical characteristics in these patients.
Here, we report a patient with azoospermia, a testicular Leydig cell tumor (LCT), and elevated plasma testosterone levels. We describe the diagnostic and therapeutic experience of this case, and our follow-up of the patient's clinical indicators and fertility status.
The patient was diagnosed with azoospermia and a testicular LCT.
The patient underwent testicular tumor removal and long-term follow-up.
After 4 months of follow-up, the patient's semen examination index significantly improved and his wife became naturally pregnant. At 4 months of gestation, the fetus was delivered because of a ruptured amniotic cavity. Twenty-six months after tumor removal, the patient's sex hormone levels had completely returned to normal and spermatogenic function had partially recovered, but there was no natural pregnancy with his partner.
For LCTs, testis sparing surgery may provide a safe and feasible option to restore spermatogenic function, although longer-term follow-up is required. Drug assistance may be required to maintain spermatogenic function and achieve fertility, and further research is required.
睾丸肿瘤占男性所有肿瘤的1%至1.5%。源自睾丸间质细胞的肿瘤较为罕见，占睾丸肿瘤的1%。睾丸间质细胞瘤细胞可产生雌激素、孕激素和睾酮等甾体激素。这些肿瘤分泌的激素量和类型可能会使这些患者产生复杂的临床特征。
在此，我们报告一名患有无精子症、睾丸间质细胞瘤（LCT）且血浆睾酮水平升高的患者。我们描述了该病例的诊断和治疗经验，以及对患者临床指标和生育状况的随访情况。
该患者被诊断为无精子症和睾丸LCT。
患者接受了睾丸肿瘤切除及长期随访。
随访4个月后，患者的精液检查指标显著改善，其妻子自然受孕。妊娠4个月时，因羊膜腔破裂导致胎儿娩出。肿瘤切除26个月后，患者的性激素水平已完全恢复正常，生精功能部分恢复，但与伴侣未自然受孕。
对于LCT，保留睾丸手术可能为恢复生精功能提供一种安全可行的选择，尽管需要更长时间的随访。可能需要药物辅助来维持生精功能并实现生育，这还需要进一步研究。
