Congenital adrenal hyperplasia and Leydig cell tumor of testis. Case report and review of literature

Adrenogenital Syndrome, more properly defined as Congenital Adrenal Hyperplasia (CAH), is related to the enzyme 21-beta-hydroxylase deficiency, with impaired glucocorticoids and aldosterone syntheses and increased ACTH synthesis. This report describes a case of a monorchid patient suffering from Adrenogenital Syndrome and Leydig cell tumor of his testis. A right orchidectomy with implantation of testis prosthesis was performed, after informing the patient on the consequences of his castration and obtaining his consent. Histology showed a testis measuring 4 x 3 x 2.5 cm with a 6 cm long spermatic cord; there was a yellowish, well-defined nodule measuring 3.5 x 1.5 cm, surrounded by normal parenchyma. This nodule had morphologic and immunohistochemical characteristics of a Leydig cell tumor, even found in the spermatic cord; those cells showed positivity to inibine, MART-1 and vimentine.