Leydig Cell Tumors Clinical Presentation

Updated: Sep 18, 2023
  • Author: Thomas Calvert, MD, MPH; Chief Editor: Edward David Kim, MD, FACS  more...
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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.


Physical Examination

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.