Testicular Estrogen-Secreting Leydig Cell Tumor in 18F-FDG PET/CT: An Incidental Detection in a Patient Treated by Chemotherapy for Hodgkin Lymphoma

Abstract We present images of a 50-year-old man who referred for treatment of a classic Hodgkin lymphoma. While 18F-FDG PET/CT demonstrated a complete metabolic remission after chemotherapy, an increased 18F-FDG uptake of a right testicular lesion in 18F-FDG PET/CT and an unexplained bilateral gynecomastia were observed. A benign Leydig cell tumor was histopathologically proved after a right radical orchiectomy. The serum estradiol level was abnormally elevated reflecting the estrogen-secreting profile. This report highlights that a focal 18F-FDG uptake in the testicular region with unexplained gynecomastia should suggest the diagnosis of an estrogen-secreting Leydig cell tumor on 18F-FDG PET/CT. Received for publication August 23, 2017; revision accepted October 30, 2017. Conflicts of interest and sources of funding: none declared. All authors have approved the manuscript and agree with its submission to this journal. The procedure followed was in accordance with the ethical standards guidelines of the responsible committee on human experimentation. Correspondence to: Axel van der Gucht, MD, Department of Nuclear Medicine, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland. E-mail: axel.van-der-gucht@chuv.ch. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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