Medscape is available in 5 Language Editions – Choose your Edition here.


Leydig Cell Tumors Clinical Presentation

  • Author: Edmund S Sabanegh, Jr, MD; Chief Editor: Edward David Kim, MD, FACS  more...
Updated: Apr 17, 2015


In most cases, patients present with an incidental finding of a testicular mass on scrotal ultrasonography during evaluation of hydroceles or varicoceles or during workup of other conditions (eg, infertility). A nontender palpable testicular mass or nodule may be noted.

Prepubertal boys with androgen-secreting tumors may present with precocious puberty; features may include prominent external genitalia, pubic hair growth, accelerated skeletal and muscle development, and mature masculine voice. Boys with estrogen-secreting tumors may present with feminizing symptoms such as gynecomastia, breast tenderness, and gonadogenital underdevelopment.

Adults with androgen-secreting tumors are generally asymptomatic. In adults with estrogen-secreting tumors, symptoms such as loss of libido, erectile dysfunction, and infertility have been reported.



An intratesticular mass may be palpated in patients with Leydig cell tumors. In children, early pubertal and musculoskeletal development may be appreciated. In adults, gynecomastia, feminine hair distribution, and/or gonadogenital atrophy may be observed.

Contributor Information and Disclosures

Edmund S Sabanegh, Jr, MD Chairman, Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation

Edmund S Sabanegh, Jr, MD is a member of the following medical societies: American Medical Association, American Society of Andrology, Society of Reproductive Surgeons, Society for the Study of Male Reproduction, American Society for Reproductive Medicine, American Urological Association, SWOG

Disclosure: Nothing to disclose.


Anil A Thomas, MD Urologist, Department of Urology, Sunnybrook Medical Office,Kaiser Permanente

Anil A Thomas, MD is a member of the following medical societies: American Urological Association, Endourological Society, Society of Robotic Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Edward David Kim, MD, FACS Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, Tennessee Medical Association, Sexual Medicine Society of North America, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Repros.

Additional Contributors

Erik T Goluboff, MD Professor, Department of Urology, College of Physicians and Surgeons, Columbia University College of Physicians and Surgeons; Director of Urology, Allen Pavilion, New York Presbyterian Hospital

Erik T Goluboff, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Urological Association, Medical Society of the State of New York, New York Academy of Medicine, Phi Beta Kappa, Society for Basic Urologic Research

Disclosure: Nothing to disclose.


Scott Rutchik, MD Assistant Professor, Department of Surgery, Division of Urology, University of Connecticut School of Medicine

Scott Rutchik, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Dan Theodorescu, MD, PhD Paul A Bunn Professor of Cancer Research, Professor of Surgery and Pharmacology, Director, University of Colorado Comprehensive Cancer Center

Dan Theodorescu, MD, PhD is a member of the following medical societies: American Cancer Society, American College of Surgeons, American Urological Association, Medical Society of Virginia, Society for Basic Urologic Research, and Society of Urologic Oncology

Disclosure: Key Genomics Ownership interest Co-Founder-50% Stock Ownership; KromaTiD, Inc Stock Options Board membership

  1. Leonhartsberger N, Ramoner R, Aigner F, Stoehr B, Pichler R, Zangerl F, et al. Increased incidence of Leydig cell tumours of the testis in the era of improved imaging techniques. BJU Int. 2011 Nov. 108(10):1603-7. [Medline].

  2. Lock G, Schmidt C, Helmich F, Stolle E, Dieckmann KP. Early experience with contrast-enhanced ultrasound in the diagnosis of testicular masses: a feasibility study. Urology. 2011 May. 77(5):1049-53. [Medline].

  3. Bozzini G, Picozzi S, Gadda F, Colombo R, Decobelli O, Palou J, et al. Long-Term Follow-Up Using Testicle-Sparing Surgery for Leydig Cell Tumor. Clin Genitourin Cancer. 2013 Jan 10. [Medline].

  4. Henderson CG, Ahmed AA, Sesterhenn I, Belman AB, Rushton HG. Enucleation for prepubertal leydig cell tumor. J Urol. 2006 Aug. 176(2):703-5. [Medline].

  5. Stoop H, Kirkels W, Dohle GR, Gillis AJ, den Bakker MA, Biermann K, et al. Diagnosis of testicular carcinoma in situ '(intratubular and microinvasive)' seminoma and embryonal carcinoma using direct enzymatic alkaline phosphatase reactivity on frozen histological sections. Histopathology. 2011 Feb. 58(3):440-6. [Medline].

  6. Iczkowski KA, Bostwick DG, Roche PC, Cheville JC. Inhibin A is a sensitive and specific marker for testicular sex cord-stromal tumors. Mod Pathol. 1998 Aug. 11(8):774-9. [Medline].

  7. Augusto D, Leteurtre E, De La Taille A, Gosselin B, Leroy X. Calretinin: a valuable marker of normal and neoplastic Leydig cells of the testis. Appl Immunohistochem Mol Morphol. 2002 Jun. 10(2):159-62. [Medline].

  8. Basciani S, Brama M, Mariani S, De Luca G, Arizzi M, Vesci L, et al. Imatinib mesylate inhibits Leydig cell tumor growth: evidence for in vitro and in vivo activity. Cancer Res. 2005 Mar 1. 65(5):1897-903. [Medline].

  9. Froehner M, Beuthien-Baumann B, Dittert DD, Schuler U, Wirth MP. Lack of efficacy of imatinib in a patient with metastatic Leydig cell tumor. Cancer Chemother Pharmacol. 2006 Nov. 58(5):716-8. [Medline].

  10. Bozzini G, Rubino B, Maruccia S, Marenghi C, Casellato S, Picozzi S, et al. Role of frozen section examination in the management of testicular nodules: a useful procedure to identify benign lesions. Urol J. 2014 Jul 8. 11(3):1687-91. [Medline].

  11. Ferretti L, Sargos P, Gross-Goupil M, Izard V, Wallerand H, Huyghe E, et al. Testicular-sparing surgery for bilateral or monorchide testicular tumours: a multicenter study of long-term oncological and functional results. BJU Int. 2014 Dec. 114(6):860-4. [Medline].

  12. Al-Agha OM, Axiotis CA. An in-depth look at Leydig cell tumor of the testis. Arch Pathol Lab Med. 2007 Feb. 131(2):311-7. [Medline].

  13. Bertram KA, Bratloff B, Hodges GF, Davidson H. Treatment of malignant Leydig cell tumor. Cancer. 1991 Nov 15. 68(10):2324-9. [Medline].

  14. Brunner HG, Otten BJ. Precocious puberty in boys. N Engl J Med. 1999 Dec 2. 341(23):1763-5. [Medline].

  15. Carmignani L, Colombo R, Gadda F, Galasso G, Lania A, Palou J, et al. Conservative surgical therapy for leydig cell tumor. J Urol. 2007 Aug. 178(2):507-11; discussion 511. [Medline].

  16. Cheville JC. Classification and pathology of testicular germ cell and sex cord-stromal tumors. Urol Clin North Am. 1999 Aug. 26(3):595-609. [Medline].

  17. Dilworth JP, Farrow GM, Oesterling JE. Non-germ cell tumors of testis. Urology. 1991 May. 37(5):399-417. [Medline].

  18. Grem JL, Robins HI, Wilson KS, Gilchrist K, Trump DL. Metastatic Leydig cell tumor of the testis. Report of three cases and review of the literature. Cancer. 1986 Nov 1. 58(9):2116-9. [Medline].

  19. Holm M, Rajpert-De Meyts E, Andersson AM, Skakkebaek NE. Leydig cell micronodules are a common finding in testicular biopsies from men with impaired spermatogenesis and are associated with decreased testosterone/LH ratio. J Pathol. 2003 Mar. 199(3):378-86. [Medline].

  20. Kaufman E, Akiya F, Foucar E, Grambort F, Cartwright KC. Viralization due to Leydig cell tumor diagnosis by magnetic resonance imaging. Case management report. Clin Pediatr (Phila). 1990 Jul. 29(7):414-7. [Medline].

  21. Kim I, Young RH, Scully RE. Leydig cell tumors of the testis. A clinicopathological analysis of 40 cases and review of the literature. Am J Surg Pathol. 1985 Mar. 9(3):177-92. [Medline].

  22. Konrad D, Schoenle EJ. Ten-year follow-up in a boy with Leydig cell tumor after selective surgery. Horm Res. 1999. 51(2):96-100. [Medline].

  23. Maeda T, Itoh N, Kobayashi K, et al. Elevated serum estradiol suggesting recurrence of Leydig cell tumor nine years after radical orchiectomy. Int J Urol. 2002 Nov. 9(11):659-61. [Medline].

  24. Mineur P, De Cooman S, Hustin J, Verhoeven G, De Hertogh R. Feminizing testicular Leydig cell tumor: hormonal profile before and after unilateral orchidectomy. J Clin Endocrinol Metab. 1987 Apr. 64(4):686-91. [Medline].

  25. Ober WB, Sciagura C. Leydig, Sertoli, and Reinke: three anatomists who were on the ball. Pathol Annu. 1981. 16 Pt 1:1-13. [Medline].

  26. Testis-sparing surgery for benign testicular tumors in children. J Urol. 2001 Jun. 165(6 Pt 2):2280-3. [Medline].

Leydig cell tumors.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.