PMC10331185_01
MRI spine: bony metastatic lesion (a) involving L1 and (b) more extensively involving L5 with minimal/mild epidural tumor extension.
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Patient underwent a magnetic resonance imaging (MRI) of the thoracic and lumbar spine that demonstrated findings worrisome for osseous metastatic disease at L1 and L5 levels (Figure 1).
L5 lesion biopsy: (a) H&E-stained section shows plump polygonal cells with abundant cytoplasm with many prominent nucleoli. Immunohistochemical stains performed show staining pattern consistent with Leydig cell tumor that includes positive staining for (b) calretinin, (c) alpha-inhibin, and (d) synaptophysin (patchy).
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A metastatic lesion comprising polygonal plump cells with abundant cytoplasm and prominent nucleoli was noted (Figure 2(a)). Immunohistochemistry (IHC) performed showed that these cells were positive for calretinin, alpha-inhibin, synaptophysin (Figure 2(b) and (d)), melan-A, chromogranin, vimentin (not shown), and Ki-67 proliferative index of 7% consistent with LCTs.