PMC4615212_01
Right testicular ultrasound, showing a testicular mass with flow on Doppler.
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Testicular ultrasound showed a 6.2 x 3.6 x 4.4 cm intratesticular lesion suspicious for malignancy (Figure 1).
(A) High magnification photomicrograph of the testicular mass showing sheets of polygonal cells with abundant eosinophilic cytoplasm, distinct cell borders, and bland uniform nuclei with prominent nucleoli. Numerous Reinke crystals are present. (B) Photomicrograph of metastatic Leydig cell tumor (lower right) within the liver (upper left).
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He underwent a right radical inguinal orchiectomy with pathology showing a 5.0 cm Leydig cell tumor with negative surgical margins (Figure 2(A)). Pathology confirmed metastatic LCT with negative surgical margins (Figure 2(B)).
Abdomen and pelvis CT that shows a 16 cm mass in the right lobe of the liver, with mass effect on the surrounding tissues, with compression of the IVC.
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Three years after orchiectomy, the patient presented with right upper quadrant abdominal pain and was found to have a large 15 x 15 cm right hepatic lesion with mass effect on adjacent structures, including narrowing of the IVC on CT (Figure 3).
Abdomen and pelvis CT that shows a new retrocrural mass (arrows) and lower right pulmonary nodule (star). A previous right hepatectomy can be observed.
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A CT scan showed a new right retrocrural mass and pulmonary node (Figure 4).
Abdomen and pelvis CT that shows a right-sided retroperitoneal recurrent mass prior to cryoablation.
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A year later a follow-up CT scan revealed a new right-sided retroperitoneal mass which was treated with cryoablation (Figure 5).
PET scan that demonstrates FDG avidity of omental lymph nodes (stars) and retrocrural lesions (arrows and arrows head).
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Seven years after orchiectomy, CT/PET imaging noted FDG avid lesions on omental lymph nodes and left sided pulmonary nodules as well as liver lesions (Figure 6) with testosterone level of 6034 ng/dL.