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Leydig cell tumour‐induced bilateral gynaecomastia in a young man: endocrine abnormalities
Author(s) -
Foppiani L.,
Bernasconi D.,
Del Monte P.,
Marugo A.,
Toncini C.,
Marugo M.
Publication year - 2005
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/j.1439-0272.2004.00648.x
Subject(s) - gynecomastia , leydig cell , endocrine system , medicine , testosterone (patch) , breast enlargement , hormone , leydig cell tumor , histology , human chorionic gonadotropin , endocrinology , urology , pathology , luteinizing hormone
Summary Among the various causes of gynaecomastia, testicular malignancies are an uncommon, life‐threatening condition, which require prompt treatment. The case of a 26‐year‐old healthy man is described, who reported a 6‐month painful bilateral gynaecomastia associated with secondary hypogonadism. Normal circulating 17 β ‐oestradiol (E 2 ) levels showed an enhanced response to human chorionic gonadotrophin (hCG) testing, which led to a reduced testosterone (T)/E 2 ratio. Both clinical and hormonal findings normalized following surgical exeresis of a left testicular mass, which proved to be a Leydig cell tumour (LCT) at histology. This report underlines the importance of ultrasonographic evaluation of the testes, whenever breast enlargement occurs in a healthy man, despite unremarkable findings on testicular examination. In addition, our case demonstrates that normal unstimulated circulating E 2 levels do not allow the presence of a stromal testicular tumour to be ruled out and that the response of restored T levels to hCG testing can remain blunted up to 1 year after surgery. Finally, we claim that T/E 2 ratio may be a useful tool in evaluating derangement of the endocrine milieu secondary to LCT.