| A 35-year-old patient was admitted to our emergency department with an ultrasound finding compatible with testicular neoplasia. | |
| His personal history included bilateral cryptorchidism that was treated with orchidopexy at 6 and 8 years, respectively, in another center. | |
| Endoscopic urethrotomy at age 20. | |
| She had recurrent nephritic colic with lithiasis and had even required treatment with ESWL. | |
| Ureterectomy was performed at 28 years of age. | |
| Smoker of 1 pack of cigarettes/day | |
| One month before, she consulted the area urologist for infertility and left testicle nodule of months of evolution that had increased in size in recent weeks. | |
| Spermogram showed total azoospermia. | |
| Testicular Doppler ultrasound was reported as a right testicle with a 19 x 23 mm mass in the upper pole with increased flow, compatible with testicular tumor and left cord cyst. | |
| Physical examination revealed a left testicle with no abnormalities and an epididymis cyst in the head. | |
| The right testicle could not be explored because it was in the inguinal canal. | |
| The study was completed. | |
| The chest X-ray was normal and there was no metastasis in the abdominal-pelvic CT scan. | |
| The laboratory analysis did not show any changes in serum hormone levels or tumor markers (alpha-fetoprotein 2.2 ng/ml, beta-HCG 0.0 ng/ml). | |
| Right inguinal radical orchiectomy and inguinal biopsy of the left testicle were performed. | |
| The macroscopic report of the piece was informed as: right testicle of 3.2 x 3 cm. The testicular piece is not observed if it is not located in the tunica vaginalis. | |
| At the cut, a solid, well-defined nodule measuring 1.5 cm in diameter was identified, with a brownish central area. | |
| The remaining testicular tissue is tan-coloured. | |
| The cord is patent without alterations. | |
| Biopsy of the left testicle is a 0.3 cm brownish fragment. | |
| Histopathological report showed Leydig cell tumor of 3.2 x 3 cm without objectifying epididymis pigmentation, tunica albuginia or vascular invasion. | |
| Testicular parenchymal remnant with Leydig cell hyperplasia in the interstice and practice absence of spermiogenesis. | |
| Free surgical margins. | |
| The biopsy of the left testis was informed as testicular with absence of spermiogenesis and hyperplasia of interstitial Leydig cells. | |
| After 30 months of follow-up, the patient presented a good general condition without radiological evidence of metastases and tumor markers within normal limits. | |