| A 36 year old patient was admitted to our Department of Surgery for inguinal hernia. No additional tests were performed. | |
| We performed a careful physical examination in which no tests were performed, so the pertinent complementary examinations were requested. | |
| Ultrasound, CT and MRI allow us to identify both tests in the inguinal canal without objectifying in them images suggestive of tumor. | |
| Seminogram showed azoospermia and in blood analysis the testosterone values were 2.5 ng/ml (2.8-11.5 ng/ml), FSH beta determination: 65 U/I and LH-fet tumor markers: 30U/I. | |
| It was decided to perform bilateral orchidopexy and testicular biopsy. | |
| The biopsy of the right testicle was informed as Leydig cell tumor, reason why we proceeded to perform right inguinal orchiectomy. | |
| The macroscopic appearance of the specimen showed a testicular parenchyma with slightly darker than normal coloration, slight micronodular appearance and fibrous striae on its surface. | |
| Histologically, it corresponded to a Leydig cell tumor occupying the entire testicle, canals and septa among the tumoral masses that showed complete disappearance. | |
| There was no invasion of the albuginea or extratesticular structures, few cellular atypia and mitosis almost absent. | |
| Biopsy of the left testicle showed no abnormalities. | |
| One month after surgery, the patient was treated with Testosterone depot. | |
| Chest X-rays and chest CT scans showed no abnormalities. | |
| Analytical and imaging controls were normal up to 30 months after orchiectomy, a time when several hypodense lesions were detected on ultrasound and CT scan, which were reported as metastases after performing MRI. | |
| The patient was treated with polychemotherapy with Bleomycin, Etoposide and Cisplatino (B.E.P.). | |
| Four cycles were administered, with good tolerance and disappearance of liver lesions after the second cycle. | |
| Twelve years after the intervention the patient is asymptomatic, incorporated into the working life, with good androgenization after a subtitutive treatment, with a Karnofski index of 100%, negative tumor markers in unknown studies and absence of metastases. | |