title: [Testicular malignant Leydig cell tumor: A case report].
abstract: OBJECTIVE
  To investigate the clinicopathological features of testicular malignant Leydig cell tumor (TMLCT) and improve the non-invasive diagnosis of the disease.
  
  
  METHODS
  We retrospectively analyzed the clinicopathological data on a case of TMLCT, detected the circulating tumor cells (CTC) in the peripheral venous blood, and reviewed the related literature.
  
  
  RESULTS
  The patient, a 47-year-old male, underwent radical orchidoepididymectomy under general anesthesia. Postoperative pathology confirmed the lesion to be TMLCT, which was mainly composed of Leydig cells and suspected with vessel carcinoma embolus. Immunohistochemistry showed the tumor cells to be positive for α-inhibin, Ki67, CD30, vimentin, EMA, and PLAP, but negative for CK, CK7, S100, CD10, SMA, Des, AFP, hCG, CEA, CK19, CD117, Oct-4, LCA, CD20, Pax-5, CD3, and CD43. Two CTCs were detected in the peripheral venous blood. The patient received 3 courses of chemotherapy for retroperitoneal multiple lymph nodes metastasis post-operatively. Subsequent CT imaging manifested no obvious reduction of the retroperitoneal lymph nodes and consequently the patient again underwent retroperitoneal lymphadenectomy and cryoablation. At 8 months after treatment, CT examination revealed notably enlarged retroperitoneal lymph nodes with the right adrenal gland evidently invaded.
  
  
  CONCLUSIONS
  TMLCT is an extremely rare sex-gonad stromal tumor with high malignancy and poor prognosis, and CTCs may be used for its early diagnosis and prognostic prediction.
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Meng
authors.initials: M
authors.lastname: Zhang
authors.forename: Shu-peng
authors.initials: SP
authors.lastname: Wang
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.forename: Zhi-ming
authors.initials: ZM
authors.lastname: Cai
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007984:Leydig Cell Tumor / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D011379:Prognosis; D012189:Retrospective Studies; D018312:Sex Cord-Gonadal Stromal Tumors / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor