睾丸癌占男性全部癌症的1-1.5%,性索间质肿瘤包括5%的睾丸癌。这项研究旨在报告同一患者同时出现的仅支持细胞综合征和睾丸间质细胞肿瘤。一名32岁男子,有3年的原发性不孕症病史。体格检查显示正常的第二性征。两次连续的精液分析显示无精子症。阴囊超声扫描显示28×27毫米的低回声和高血管右睾丸肿块。进行右睾丸根治性切除术并同时进行左睾丸活检。组织病理学检查显示仅支持细胞综合征和Leydig细胞肿瘤伴有局灶性Leydig细胞增生。在文献中很少提到在治疗Leydig细胞肿瘤后逆转生育能力。一项研究表明,原发性不育男性在经过4个月的管理后,生育能力得以恢复。然而,由于SCOS导致的非阻塞性无精子症的不育男性只能通过睾丸精子提取技术生一个孩子。尽管Leydig细胞瘤很少发生,在患有无精子症的不育男性中,可以看到它与仅支持细胞综合征相关。临床检查和影像学检查对这些患者很重要,因为其中睾丸肿块的可能性很高。
Testicular cancers comprise 1-1.5% of entire cancers in men, and sex cord-stromal tumors include 5% of testicular cancers. This study aims to report a simultaneous Sertoli cell-only syndrome and Leydig cell tumor in the same patient. A 32-year-old man presented with a history of primary infertility for 3 years. Physical examination revealed normal secondary sexual characteristics. Two successive seminal fluid analyses revealed azoospermia. A scrotal ultrasound scan showed a 28 × 27 mm hypoechoic and hypervascular right testicular mass. Right radical orchiectomy and simultaneous left testicular biopsy were conducted. The histopathological examination revealed Sertoli cell-only syndrome and Leydig cell tumor with focal Leydig cell hyperplasia. Reversing fertility following the management of Leydig cell tumor is rarely mentioned in the literature. A study revealed that fertility recovered following 4 months of management in a primary infertile male. However, infertile men with nonobstructive azoospermia due to SCOS can only have a child by testicular sperm extraction technique. Despite the rare occurrence of Leydig cell tumor, it could be seen in association with Sertoli cell-only syndrome in infertile men with azoospermia. Clinical examination and imaging studies are important in these patients as the possibility of having a testicular mass is high among them.