Abstract:
Leydig Cell Tumor (LCT) is very rare in adults. It constitutes only 1% of total testicular tumors. LCTs can produce steroid hormones such as estrogen, progesterone, and testosterone. Sertoli cells are found in seminiferous tubules, they are part of the blood-testis barrier. Sertoli Cells Only Syndrome (SCOS) also known as germ cell aplasia is characterized by azoospermia in which the seminiferous tubules of testicular biopsy are lined only with Sertoli cells. The expected hormone profile in SCOS is increased FSH with normal T and LH. The expected hormone profile in LCT is increased/normal FSH and LH with increased T or E2. A patient presented to our clinic with a well-circumscribed mass in his right testicle and underwent radical orchiectomy. Tumor markers were negative. Azoospermia was detected in the spermiogram. T and E2 were normal, FSH, and LH were high. Right radical orchiectomy was performed. A combination of LCT and SCOS were reported in pathology results. Azoospermia cases secondary to high androgen levels are frequently encountered in LCTs. As in the case we have presented, two different testicular pathologies may present at the same time and create an unexpected hormonal picture. Such situations can cause the laboratory to mask the clinical truth.
摘要:
睾丸间质细胞瘤(LCT)在成人中非常罕见。它仅占总睾丸肿瘤的1%。LCT可以产生类固醇激素,如雌激素,黄体酮,和睾丸激素。在生精小管中发现了支持细胞,它们是血睾丸屏障的一部分.仅支持细胞综合征(SCOS)也称为生殖细胞发育不全,其特征是无精子症,其中睾丸活检的生精小管仅衬有支持细胞。在正常T和LH的情况下,SCOS中预期的激素谱是FSH增加。LCT中的预期激素谱是增加的/正常的FSH和LH,具有增加的T或E2。一位患者出现在我们的诊所,他的右睾丸中有一个界限分明的肿块,并接受了根治性睾丸切除术。肿瘤标志物阴性。在精子图中检测到无精子症。T和E2正常,FSH,LH高。行根治性睾丸切除术。病理结果报告了LCT和SCOS的组合。在LCTs中经常遇到继发于高雄激素水平的无精子症病例。正如我们所介绍的那样,两种不同的睾丸病理可能同时出现,并产生意想不到的荷尔蒙图片。这种情况可能导致实验室掩盖临床事实。