Leydig cell tumor of the testis with histological and immunohistochemical features of malignancy in a 1-year-old boy with isosexual pseudoprecocity

Int J Surg Pathol. 2006 Oct;14(4):344-8. doi: 10.1177/1066896906292452.

Abstract

The article reports the clinical, histopathological, and immunohistochemical findings of a 1-year-old boy presenting with isosexual pseudoprecocity attributable to a functioning Leydig cell tumor of the testis. The case appears to represent the youngest patient ever recognized with this well-known syndrome. Malignancy features were also for the first time initially assessed using criteria, retrospectively developed from the literature, for metastasizing Leydig cell tumor. All the following were found: infiltrative borders, cellular pleomorphism, high mitotic index (12-14/high-power field), high MIB-1 index (40%), P53 positivity in 50% of the cells, and bcl-2 positivity in 15% of the cells. Immunohistochemistry proved the cells of the tumor to be positive for inhibin, Melan-A, synaptophysin, cytokeratin, and calretinin and negative for S-100 and chromogranin A. Notably, lipochrome and crystals of Reinke were not found in the tumor cells. Although the neoplasm fulfilled the criteria for a potentially metastasizing Leydig cell tumor, there was no evidence of that event having occurred, perhaps as a result of early treatment or as indication that criteria developed for Leydig cell tumor of adults may not apply to children.

Publication types

  • Case Reports

MeSH terms

  • Antigens, Neoplasm / genetics
  • Antigens, Neoplasm / metabolism
  • Calbindin 2
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Immunohistochemistry
  • Infant
  • Inhibins / genetics
  • Inhibins / metabolism
  • Keratins / genetics
  • Keratins / metabolism
  • Leydig Cell Tumor / complications
  • Leydig Cell Tumor / metabolism
  • Leydig Cell Tumor / pathology*
  • MART-1 Antigen
  • Male
  • Neoplasm Proteins / genetics
  • Neoplasm Proteins / metabolism
  • Puberty, Precocious / etiology
  • Puberty, Precocious / metabolism
  • Puberty, Precocious / pathology*
  • S100 Calcium Binding Protein G / genetics
  • S100 Calcium Binding Protein G / metabolism
  • Synaptophysin / genetics
  • Synaptophysin / metabolism
  • Testicular Neoplasms / complications
  • Testicular Neoplasms / metabolism
  • Testicular Neoplasms / pathology*

Substances

  • Antigens, Neoplasm
  • CALB2 protein, human
  • Calbindin 2
  • MART-1 Antigen
  • MLANA protein, human
  • Neoplasm Proteins
  • S100 Calcium Binding Protein G
  • Synaptophysin
  • Inhibins
  • Keratins