A clinical case of leydigoma in a 4-year-old boy

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. 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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