Leydig Cell Tumours: a Case Series from a Single Irish Centre

Leydig cell tumours (LCT) are rare testicular neoplasms that usually follow a benign clinical course. Due to the aggressive, difficult-to-treat nature of metastatic disease arising from a small percentage of LCTs, it is imperative to understand and recognize how to identify those tumours which exhibit features that predict malignant behaviour in order to guide initial surgical and oncological management. By using the well-described high-risk histopathological features of Leydig cell tumours as guidance, the management of LCTs has evolved to commonly include testis-sparing surgery (TSS), in patients who historically would have undergone a complete orchidectomy. Thus, assessment of the clinicopathological features of Leydig cell tumours allows for optimal management of this rare disease, whilst modern technologies and surgical techniques have altered the potential treatment landscape. This does not replace the need for the urologist and medical oncologist to remain vigilant in the risk-stratification of patients presenting with these rare testicular sex cord stromal tumours. We present three cases of patients diagnosed with Leydig cell tumours in a single institution in Dublin, Ireland, between 2016 and 2020 and discuss how the clinicopathological features dictate the management and subsequent follow-up for patients presenting with these rare tumours.