endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg13022endoserg-13022Research ArticleКлинический случайClinical CaseКлинический случай лейдигомы у мальчика 4 летA clinical case of leydigoma in a 4-year-old boyhttps://orcid.org/0000-0002-6448-6842АникиевА. В.AnikievA. V.

Аникиев Александр Вячеславович, к.м.н., врач отделения детской хирургии  

117036, Москва, Россия, ул. Дм. Ульянова, д. 11 

Alexander V. Anikiev, MD, PhD 

11 Dm.Ulyanova street, 117036 Moscow 

anikieal70@gmail.comhttps://orcid.org/0000-0002-3734-6510БровинД. Н.BrovinD. N.

Бровин Дмитрий Николаевич, к.м.н.  

Москва 

Dmitriy N. Brovin, MD, PhD 

Moscow 

brovin-dn@yandex.ruhttps://orcid.org/0000-0002-4667-214XВолодькоЕ. А.VolodkoE. A.

Володько Елена Анатольевна, д.м.н.  

Москва 

Elena A. Volodko, MD, PhD

Moscow 

elena-volodko@mail.ruhttps://orcid.org/0009-0000-1383-8636НоволодскаяК. И.NovolodskayaK. I.

Новолодская Кристина Ивановна  

Москва 

Kristina I. Novolodskaya 

Moscow 

mstivarjag88@gmail.comhttps://orcid.org/0000-0002-6822-0435ПастуховаД. А.PastuchovaD. A.

Пастухова Дария Алексеевна 

Москва 

Daria A. Pastuchova, MD

Moscow 

pastuhova.dariya@endocrincentr.ruhttps://orcid.org/0000-0002-4690-8095ЛатышевО. Ю.LatyshevO. Yu.

Латышев Олег Юрьевич, к.м.н. 

Москва 

Oleg Y. Latyshev, MD, PhD 

Moscow 

olatyshev1975@mail.ruhttps://orcid.org/0000-0003-4915-1267ЧугуновИ. С.ChugunovI. S.

Чугунов Игорь Сергеевич, к.м.н.  

Москва 

Igor S.Chugunov, MD, PhD 

Moscow 

chugunov.igor@endocrincentr.ruГНЦ РФ «Национальный медицинский исследовательский центр эндокринологии имени академика И.И. Дедова»РоссияResearch Center of Endocrinology, Ministry of Health of the Russian FederationRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования»РоссияRussian Medical Academy of Continuous Postgraduate Education of the Ministry of Health of the Russian FederationRussian Federation2025060420261942834Copyright © Аникиев А.В., Бровин Д.Н., Володько Е.А., Новолодская К.И., Пастухова Д.А., Латышев О.Ю., Чугунов И.С., 20262026Аникиев А.В., Бровин Д.Н., Володько Е.А., Новолодская К.И., Пастухова Д.А., Латышев О.Ю., Чугунов И.С.Anikiev A.V., Brovin D.N., Volodko E.A., Novolodskaya K.I., Pastuchova D.A., Latyshev O.Y., Chugunov I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/13022ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Лейдигома — это гормонально активная опухоль, развивающаяся из клеток Лейдига, продуцирующих тестостерон. Избыточная продукция опухолью тестостерона у мальчиков допубертатного возраста приводит к гонадотропин-независимому преждевременному половому созреванию. Основной метод лечения лейдигомы — хирургический. Предметом обсуждения остается объем оперативного вмешательства.

ОПИСАНИЕ КЛИНИЧЕСКОГО СЛУЧАЯ. Пациент, 4 года 7 мес, поступил с жалобами на увеличение размеров правого яичка и полового члена в течение полутора лет и прогрессирующее оволосение у основания полового члена в течение двух месяцев. По месту жительства выявлено увеличение секреции тестостерона, эхографические признаки объемного образования правого яичка и отрицательные показатели онкомаркеров. В результате обследования заподозрена лейдигома правого яичка. C целью исключения злокачественного процесса проведена компьютерная томография органов брюшной полости, забрюшинного пространства и малого таза с рентгенконтрастным усилением. Объемных образований, очагов, патологически накапливающих контрастное вещество в брюшной полости и забрюшинном пространстве, не выявлено. Выполнена скрототомия и удаление опухоли правого яичка.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Лейдигома — заболевание яичек, которое сопровождается клиникой преждевременного полового созревания. Редкость данной патологии оказывает существенное влияние на сроки диагностики. Они как правило поздние, что влечет за собой необратимые изменения, которые появляются в организме пациента вследствие длительной гиперсекреции тестостерона. Основной метод лечения — хирургический. Выбор хирургической тактики обоснован размерами опухоли и риском злокачественного образования. Пациенты требуют длительного наблюдения в связи с риском развития преждевременного гонадотропин-зависимого полового созревания и его последствий.

INTRODUCTION

INTRODUCTION. A leydigoma is a hormone-active tumor that develops from Leydig cells that produce testosterone. Excessive production of testosterone by the tumor in pre-puberty boys leads to gonadotropin-independent premature puberty. The main treatment method for leydigoma is surgical. The volume of surgical intervention remains the subject of discussion.

DESCRIPTION OF THE CLINICAL CASE. A patient aged 4 years and 7 months was admitted complaining of an increase in the size of the right testicle and penis for one and a half year and progressive hair growth at the base of the penis for two months. An increase in testosterone secretion, echographic signs of bulky formation of the right testicle and negative indicators of cancer markers were revealed at the place of residence. As a result of the examination, a leydigoma of the right testicle was suspected. In order to exclude the malignant process, computed tomography of the abdominal cavity, retroperitoneal space and small pelvis with X-ray contrast enhancement was performed. No volumetric formations or foci pathologically accumulating contrast agent in the abdominal cavity and retroperitoneal space were detected. A scrototomy and removal of the tumor of the right testicle were performed.

CONCLUSION

CONCLUSION. Leydigoma is a testicular disease that is accompanied by a clinic of premature puberty. The rarity of this pathology has a significant impact on the timing of diagnosis. They are usually late, which entails irreversible changes that appear in the patient's body due to prolonged hypersecretion of testosterone. The main treatment method is surgical. The choice of surgical tactics is justified by the size of the tumor and the risk of malignancy. Patients require long-term follow-up due to the risk of developing premature gonadotropin-dependent puberty and its consequences.

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The authors declare that there are no conflicts of interest present.