PMC3687613_01
The 5-yr-old patient showing a prominent external genitalia and no palpable testicular mass.
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The parents noticed a penis enlargement and recent growth spurt with deepening of the voice (Fig. 1).
Sonographic findings of the affected testicle: solid nodule 2.5 x 1.7 cm embedded within the testicle and no involvement of the tunica albuginea and epididymis.
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The lesion was hyperechogenic, homogeneous and poorly vascularized (Fig. 2).
Macroscopic appearance of the tumour (dark brown in color, 2.5 x 1.7 x 0.8 cm in size) showing minimal testicular tissue surrounding the well-circumscribed mass.
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Pathologic examination of the right testis revealed a well-circumscribed encapsulated solid nodule of 2.5 x 1.7 x 0.8 cm in size embedded within the testicle (Fig. 3).
(A) Microscopic characteristics of Leydig cell tumor of the testis showing a granular acidophilic cytoplasm, prominent nucleolus and rare mitosis (HE x 40). (B) Positive inmunohistochemical findings with vimentin. (C) The cytoplasm of the tumor cells is strongly reactive to inhibin.
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Immunohistochemically, vimentin, Melan A (Mart-1) and inhibin were expressed in the cytoplasm of the tumor's cells (Fig. 4).