LCTs are prevailing kind of sex cord stromal tumors. They are typically benign with only 5-10% exhibiting malignant characteristics. These growths demonstrate a bimodal distribution pattern with peaks during the pre-pubertal age group as well as between the ages of 30 and 60 years.

We present the case of a 33-year-old Malaysian-Malay-man, who has been an active smoker for more than 12 years. He initially came to sought urological consultation for his primary infertility. On examination, an incidental finding of a 4cm x 4cm, firm and non-tender left scrotal mass was made. His tumor markers were normal, surprisingly his testosterone hormone was elevated, >52nmol/L, with low LH (0.3 IU/L) and FSH (0.3 IU/L). Testicular USG revealed multiple left intratesticular lesions. Subsequently, he underwent left inguinal orchidectomy. During surgery, a 4cm x 5cm left testicular tumor was removed. HPE it positive staining for inhibin, calrectinin and focally weak androgen receptor. Post operative his testosterone level normalize to 7.2nmol/L. He is currently asymptomatic.

LCTs have a strong correlation with male infertility and cryptorchidism. Blood tumor markers such as AFP , BHCG , and LDH are typically normal. USG of testes has been very useful to confirm the diagnosis of testicular tumor, but it cannot differentiate between a benign and maglinant tumour. The conclusive identification of LCTs requires a HPE of orchiectomy specimen. Surgery remains the mainstay treatment. Radical inguinal orchidectomy which involve in remove affected testis and spermatic cord.

This case study highlights the paramount significance of maintaining a vigilant and discerning clinical stance for LCTs in males presenting with testicular masses. Knowledge of this uncommon tumor entity is important as endocrine manifestations could be the only sign for the presence of these tumors. Early diagnosis and intervention may attain long-term favorable oncological, function and fertility outcomes.‌