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© 2004 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 23:959-964 • 0278-4297

Case Series

Leydig Cell Tumors of the Testis

Gray Scale and Color Doppler Sonographic Appearance

Zeev V. Maizlin, MD, Alexander Belenky, MD, Myriam Kunichezky, MD, Judith Sandbank, MD and Simon Strauss, MB, ChB

Departments of Radiology (Z.V.M., S.S.) and Pathology (J.S.), Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; and Departments of Radiology (A.B.) and Pathology (M.K.), Rabin Medical Center, Petach Tikva, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Address correspondence and reprint requests to Simon Strauss, MB, ChB, Department of Radiology, Assaf Harofeh Medical Center, Zerifin 70300, Israel. E-mail: drstraus{at}netvision.net.il.

Objective. To determine the gray scale and color Doppler sonographic features of Leydig cell tumors of the testis in a series of patients. Methods. We retrospectively analyzed the sonographic appearance of 10 proven Leydig cell tumors in 9 patients aged 26 to 47 years. Sonographic features that were reviewed included the size and echogenicity of the tumors, presence of cystic areas or calcifications, and distribution pattern of detectable blood flow on color or power Doppler imaging. Results. The tumors ranged from 0.4 to 3.0 cm in diameter, but most were less than 1.0 cm in diameter. In 1 testis, 2 discrete Leydig cell tumors were found. Nine (90%) of the 10 tumors were homogeneously hypoechoic. Only 1 tumor was isoechoic with the testis. None of the tumors contained calcifications. Of 8 tumors with color Doppler imaging, 7 (88%) showed a characteristic pattern of increased peripheral blood flow, which was either circumferential or punctate. Only 1 tumor was found with internal hypervascularity. Conclusions. Peripheral hypervascularity in a hypoechoic testicular tumor that has little or no internal color Doppler flow should suggest the possibility of a Leydig cell tumor, and consideration should be given to testicle-sparing surgery.

Key Words: color Doppler sonography • Leydig cell tumor • testis neoplasms • sonography

Abbreviations: LCD, Leydig cell tumor




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