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Stokkel L, van der Poel HG, Langbein SI, Kerst JM, de Jong J, van Rhijn BWG. A testosterone-producing Leydig cell tumor metastasis during hormonal treatment of prostate cancer. Urol Ann 2020; 12:180-183. [PMID: 32565659 PMCID: PMC7292439 DOI: 10.4103/ua.ua_38_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 10/29/2019] [Indexed: 11/04/2022] Open
Abstract
We describe a patient with a testosterone-producing metastasis discovered during the follow-up of prostate cancer. The patient had a history of a Leydig cell tumor (LCT) in the right testicle for which he underwent radical orchiectomy at the age of 60 years. Within a year after orchiectomy, he was diagnosed with prostate cancer. He received a radical prostatectomy with pelvic lymph node dissection. Due to recurrent prostate cancer, he underwent salvage radiation to the prostatic fossa and pelvic lymph node stations with hormonal treatment for 3 years. After approximately 1.5 years of chemical castration, a significant increase in testosterone level occurred. Further, diagnostic evaluations and surgery revealed a testosterone-producing LCT metastasis in the retroperitoneum.
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Affiliation(s)
- Laura Stokkel
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Sigrun I Langbein
- Department of Urology, Zaans Medical Center, Zaandam, The Netherlands
| | - J Martijn Kerst
- Department of Medical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Jeroen de Jong
- Department of Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Bas W G van Rhijn
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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2
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Azizi M, Aydin AM, Cheriyan SK, Peyton CC, Montanarella M, Gilbert SM, Sexton WJ. Therapeutic strategies for uncommon testis cancer histologies: teratoma with malignant transformation and malignant testicular sex cord stromal tumors. Transl Androl Urol 2020; 9:S91-S103. [PMID: 32055490 DOI: 10.21037/tau.2019.09.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Testicular cancer is the most common solid malignancy in male adolescents and young adults, with germ cell derived seminomas and non-seminomas being by far the most common histologies. Teratoma with somatic-type malignancy is a rare chemo-resistant phenotype of testis cancer associated with poor prognosis in patients with advanced stage disease. Malignant gonadal-stromal tumors comprise 5% of testicular neoplasms and approximately 10% are malignant and considered chemo-radiation resistant. Prognostic factors and treatment strategies for these uncommon histologies are lacking.
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Affiliation(s)
- Mounsif Azizi
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Ahmet M Aydin
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Salim K Cheriyan
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Charles C Peyton
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Matthew Montanarella
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Scott M Gilbert
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Wade J Sexton
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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3
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Chaker K, Sellami A, Ouanes Y, Chehida MAB, Bibi M, Krarti M, Abid K, Rhouma SB, Nouira Y. Leydig cell testicular tumors: About a case report. Urol Case Rep 2018. [PMID: 29541582 PMCID: PMC5849939 DOI: 10.1016/j.eucr.2017.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kays Chaker
- Departement of Urology La Rabta Hospital, Tunisia
| | | | | | | | - Mokhtar Bibi
- Departement of Urology La Rabta Hospital, Tunisia
| | - Mahdi Krarti
- Departement of Urology La Rabta Hospital, Tunisia
| | - Karem Abid
- Departement of Urology La Rabta Hospital, Tunisia
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4
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Chortis V, Johal NJ, Bancos I, Evans M, Skordilis K, Guest P, Cullen MH, Porfiri E, Arlt W. Mitotane treatment in patients with metastatic testicular Leydig cell tumor associated with severe androgen excess. Eur J Endocrinol 2018; 178:K21-K27. [PMID: 29330226 PMCID: PMC5811932 DOI: 10.1530/eje-17-0542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 12/20/2017] [Accepted: 01/08/2018] [Indexed: 11/11/2022]
Abstract
Mitotane (o,p'DDD) is established in the adjuvant and advanced-stage treatment of adrenocortical carcinoma and counteracts both tumor growth and tumor-related steroid production. Both the adrenal glands and the gonads are steroidogenically active organs and share a common embryogenic origin. Here, we describe the effects of mitotane in two patients with metastatic Leydig cell tumor (LCT) of the testes and associated severe androgen excess (serum testosterone 93 and 88 nmol/L, respectively; male reference range 7-27 nmol/L). Both men suffered from severe restlessness, insomnia and irritability, which they described as intolerable and disrupting normal life activities. Urinary steroid profiling by gas chromatography-mass spectrometry (GC-MS) confirmed excess androgen production and revealed concurrent overproduction of glucocorticoids and glucocorticoid precursors, which under physiological conditions are produced only by the adrenal glands but not by the gonads. In a palliative approach, they were commenced on mitotane, which achieved swift control of the hormone excess and the debilitating clinical symptoms, restoring normal quality of life. GC-MS demonstrated normalization of steroid production and decreased 5α-reductase activity, resulting in decreased androgen activation, and imaging demonstrated disease stabilization for 4-10 months. In conclusion, mitotane can be highly effective in controlling steroid excess in metastatic LCTs, with anti-tumor activity in some cases.
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Affiliation(s)
- Vasileios Chortis
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Birmingham, UK
- Centre for EndocrinologyDiabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Nicholas J Johal
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Birmingham, UK
| | - Irina Bancos
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Birmingham, UK
- Division of EndocrinologyMetabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew Evans
- Departments of PathologyQueen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Kassiani Skordilis
- Departments of PathologyQueen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Peter Guest
- Radiology and Cancer CentreQueen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Michael H Cullen
- Cancer CentreQueen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Emilio Porfiri
- Cancer CentreQueen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Wiebke Arlt
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Birmingham, UK
- Centre for EndocrinologyDiabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
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5
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Hibi H, Yamashita K, Sumitomo M, Asada Y. Leydig cell tumor of the testis, presenting with azoospermia. Reprod Med Biol 2017; 16:392-395. [PMID: 29259494 PMCID: PMC5715892 DOI: 10.1002/rmb2.12046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/19/2017] [Indexed: 12/18/2022] Open
Abstract
Case A case of Leydig cell tumor, associated with azoospermia, is presented. Outcome The levels of sex hormones obviously were decreased, including luteinizing hormone (LH) and follicle‐stimulating hormone (FSH), with elevated testosterone. Computed tomography revealed no adrenal gland tumor, but a significant calcification in the right scrotal content was observed. He received a right radical orchiectomy and then he was unable to ejaculate. An endocrine panel revealed significantly decreased levels of testosterone and the low LH level had remained. Hormone replacement therapy with combined LH and FSH successfully recovered and preserved spermatogenesis. Conclusions Although the patient’s sexual function deteriorated after surgery, hormone replacement therapy was successful in establishing spermatogenesis.
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Affiliation(s)
- Hatsuki Hibi
- Department of Urology Kyoritsu General Hospital Nagoya Japan
| | - Kyoko Yamashita
- Department of Pathology and Biological Responses Nagoya University Graduate School of Medicine Nagoya Japan
| | - Makoto Sumitomo
- Department of Urology Aichi Medical University School of Medicine Nagakute Japan
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Prasivoravong J, Barbotin AL, Derveaux A, Leroy C, Leroy X, Puech P, Mitchell V, Marcelli F, Rigot JM. Leydig cell tumor of the testis with azoospermia and elevated delta4 androstenedione: case report. Basic Clin Androl 2016; 26:14. [PMID: 27833751 PMCID: PMC5100078 DOI: 10.1186/s12610-016-0041-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/14/2016] [Indexed: 12/27/2022] Open
Abstract
Background Secreting interstitial cell (Leydig cell) tumors are rare. In adults, the clinical picture and steroid levels are variable. Case presentation This paper presents a case of left testicular tumor, showing azoospermia with normal serum level of total testosterone, collapsed FSH and LH, and high delta4 androstenedione. Histopathological investigation revealed a Leydig cell tumor. TESE allowed spermatozoa extraction and freezing. Testicular histology found hypospermatogenesis and germ-cell aplasia with interstitial fibrosis. Surgical resection of the tumor resulted in normalization of gonadotropins and fall in serum delta4 androstenedione to subnormal levels in the postoperative period confirming that the tumor was secreting delta4 androstenedione. It was hypothesized that high delta4 androstenedione resulted in intra tumoral 17 β-HSD overtaken by delta4 androstenedione or that 17 β-HSD activity in the tumor was different from that of normal Leydig cells. Three months after surgery sperm analysis found a complete recovery of spermatogenesis. A spontaneous pregnancy occurred 3 months after surgery and a girl was born. Conclusions In this case, the diagnosis of testicular Leydig cell tumor secreting delta4 androstenedione was made in a context of azoospermia.
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Affiliation(s)
- J Prasivoravong
- Department of Andrology, Lille University Hospital, Lille, France ; Department of Andrology, CHRU Lille, Hôpital Calmette, Boulevard du Professeur Leclercq, 59037 Lille Cedex, France
| | - A-L Barbotin
- Biology of Reproduction Unit, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
| | - A Derveaux
- Department of Andrology, Lille University Hospital, Lille, France
| | - C Leroy
- Department of Andrology, Lille University Hospital, Lille, France
| | - X Leroy
- Department of Pathology, Lille University Hospital, Lille, France
| | - P Puech
- Department of Radiology, Lille University Hospital, Lille, France
| | - V Mitchell
- Biology of Reproduction Unit, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
| | - F Marcelli
- Department of Andrology, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
| | - J-M Rigot
- Department of Andrology, Lille University Hospital, Lille, France ; EA4308 Gametogenesis and Gamete Quality, University of Lille, Lille, France
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7
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Rove KO, Maroni PD, Cost CR, Fairclough DL, Giannarini G, Harris AK, Schultz KAP, Cost NG. Pathologic Risk Factors for Metastatic Disease in Postpubertal Patients With Clinical Stage I Testicular Stromal Tumors. Urology 2016; 97:138-144. [DOI: 10.1016/j.urology.2016.06.066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/02/2016] [Accepted: 06/08/2016] [Indexed: 11/26/2022]
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Tazi MF, Ahsaini M, Khalouk A, Fassi MJ, Farih MH. Les tumeurs testiculaires à cellules de Leydig: à propos de quatre cas et revue de la littérature. Basic Clin Androl 2011. [DOI: 10.1007/s12610-010-0114-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Résumé
Introduction
Les tumeurs testiculaires à cellules de Leydig (TTCL) sont rares, elles représentent entre 1 et 3 % de l’ensemble des tumeurs testiculaires, ce sont les plus fréquentes des tumeurs des cordons sexuels et du stroma. Ces tumeurs se développent le plus fréquemment (55 %) chez les sujets jeunes de 15 à 35 ans, mais elles peuvent se voir aussi chez les enfants lors de la première décennie (20 %) et chez les hommes après 50 ans (25 %). Le mode de révélation le plus fréquent chez l’adulte est la gynécomastie, par contre chez l’enfant, c’est la pseudopuberté précoce isosexuelle. Elles posent le problème de leur diagnostic biologique devant des formes non palpables et du choix de leur traitement chirurgical en raison de la difficulté diagnostique entre les formes bénignes et malignes.
Matériel et méthodes
Nous rapportons quatre présentations différentes de cette pathologie dont les paramètres étudiés seront l’âge, le mode de révélation, le profil hormonal, le type de traitement et le mode évolutif.
Résultats
L’âge moyen de nos patients était de 37 ans et demi. Le mode de révélation était deux fois sur quatre en rapport avec une grosse bourse unilatérale, une fois pour grosse bourse bilatérale, une fois en rapport avec une gynécomastie. Dans tous les cas, la testostérone était normale ou basse et l’estradiol normal ou élevé. Les quatre patients ont subi une orchidectomie associée à une énucléation controlatérale chez un seul des patients. L’évolution était favorable pour tous nos patients, avec un recul moyen de 15 mois.
Conclusion
Le but de cette revue est de présenter, sur la base de quatre observations cliniques différentes et de l’analyse de la littérature, les différents aspects cliniques, biologiques, radiologiques pathologiques et thérapeutiques des TTCL.
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Tazi MF, Ahallal Y, Znati K, El Fassi MJ, Farih MH. Tumeur testiculaire bilatérale synchrone à cellules de Leydig: à propos d’un cas. Basic Clin Androl 2009. [DOI: 10.1007/s12610-009-0014-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Résumé
Les tumeurs testiculaires à cellules de Leydig sont rares, elles représentent entre 1 et 3 % de l’ensemble des tumeurs testiculaires. L’atteinte bilatérale synchrone est exceptionnelle. Découverte dans 20 % des cas lors de la première décennie, elle peut être retrouvée dans toutes les tranches d’âge, le diagnostic étant effectué après 50 ans dans 25 % des cas. Le diagnostic est classiquement suspecté devant une anomalie sécrétoire intéressant les hormones sexuelles et seule l’histologie confirme le diagnostic. Nous rapportons le cas d’un patient âgé de 25 ans qui présente une tumeur bilatérale synchrone à cellules de Leydig traité par orchidectomie unilatérale et tumorectomie controlatérale.
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10
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Management of non-germinal testicular tumors. World J Urol 2009; 27:507-12. [DOI: 10.1007/s00345-009-0403-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 03/04/2009] [Indexed: 01/24/2023] Open
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11
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Slama A, Elleuch A, Yacoubi MT, Ben Sorba N, Mosbah AT. [Bilateral Leydig cell tumor of the test: a case report]. ANNALES D'UROLOGIE 2003; 37:213-6. [PMID: 12951717 DOI: 10.1016/s0003-4401(03)00045-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Testicular Leydig cell tumours are uncommon. Bilateral synchronous lesions are exceptional. They cause isosexual pseudo precocious puberty in childhood. The histological diagnosis of malignancy is sometimes difficult to establish and it can be made retrospectively when lymph nodes involvement or visceral metastasis appear in the follow-up. We report a case of a 9 year-old boy presenting bilateral Leydig cell tumour of the testis treated by bilateral radical orchiectomy who developed 2 years after the intervention a pulmonary metastasis.
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Affiliation(s)
- Adel Slama
- Service d'urologie, CHU Sahloul 4054 Sousse, Tunisie.
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12
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Sawin PD, VanGilder JC. Spinal cord compression from metastatic Leydig's cell tumor of the testis: case report. Neurosurgery 1996; 38:407-11. [PMID: 8869074 DOI: 10.1097/00006123-199602000-00037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
A case of spinal cord compression from metastatic Leydig's cell tumor of the testis is presented. This 67-year-old man exhibited paraparesis and neurogenic bladder dysfunction secondary to a spinal epidural mass at the T5 level as the initial manifestation of his cancer. Surgical resection was undertaken for tissue diagnosis and spinal cord decompression. The histopathological features of the epidural mass and the excised left testicle were identical, indicative of Leydig's cell carcinoma. The literature is reviewed for previous experience with this exceedingly rare tumor. Unlike most metastatic spinal malignancies, radiation therapy is an ineffectual treatment modality for this tumor. Surgical resection is the only therapeutic option available for amelioration of spinal cord compression.
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Affiliation(s)
- P D Sawin
- Division of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA
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Di Tonno F, D'INCà G, Bertoldin R, Vianello F, Di Pietro R, Lavelli D, Guazzieri S. Role of retroperitoneal lymph node dissection in clinical stage I Leydig cell tumours. Urologia 1996. [DOI: 10.1177/039156039606301s20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Leydig Cell Tumours (LCT) account for 3% of all testicular tumours; 10% are malignant and are refractory to radio- and chemotherapy. The role of Retroperitoneal Lymph Node Dissection in clinical stage I LCT is therefore a particularly debated one. From March ‘83 to December ‘95, 10 patients with LCT were subjected to orchiectomy (1 of them bilaterally because of a metachronous tumour). In 10 out of 11 specimens the following pathological features – a) size larger than 50 mm, b) infiltration of spermatic cord, c) lymphatics and veins, d) capsule, e) necrosis, f) cellular pleomorphism, g) numerous mitoses, h) nuclear atypia – were absent. The only patient in which b) and d) were present was subjected to RPLND. After a follow-up ranging from 17 to 157 months all patients are disease-free. Abstention from RPLND in clinical stage I LCT therefore seems the more rational choice when the above- listed pathologic features are absent.
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Affiliation(s)
- F. Di Tonno
- Divisione Urologica - Ospedale Civile - Camposampiero (Padova)
| | - G. D'INCà
- Divisione Urologica - Ospedale Civile - Belluno
| | | | - F. Vianello
- Divisione Urologica - Ospedale Civile - Camposampiero (Padova)
| | - R. Di Pietro
- Servizio di Anatomia Patologica - Ospedale Civile - Camposampiero (Padova)
| | - D. Lavelli
- Divisione Urologica - Ospedale Civile - Camposampiero (Padova)
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Abstract
At our regional centre, 504 patients with testicular tumour were treated from 1 January 1980 to 31 December 1993. In the course of the treatment, 10 patients (2%) with gonadal stromal cell testicular tumours were found. Histopathological examination identified Sertoli cells in 3 cases, granulosa cells in 1 case, and Leydig cell primary tumours in 6 cases. Leydig cell testicular tumours, the most significant clinically, should not be regarded as benign. In 3 of 6 cases metastatic processes developed. Three patients died in spite of the surgical and chemotherapeutic interventions. Analysis of these cases suggests that, following the semicastration of Leydig cell testicular tumours, a primary retroperitoneal lymph node dissection should be performed, and an exact identification of the pathological stage should be carried out.
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Affiliation(s)
- L Farkas
- Urological Institute of the Medical School, Pécs, Hungary
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15
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Kirsch AJ, Bastian W, Cohen HL, Glassberg KI. Precocious puberty in a child with unilateral Leydig cell tumor of the testis following orchiopexy. J Urol 1993; 150:1483-5. [PMID: 8105109 DOI: 10.1016/s0022-5347(17)35819-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A case of right testicular Leydig cell tumor in a 10 1/2-year-old child with precocious puberty is reported. Significant history included right orchiopexy for cryptorchidism when the boy was 7 years old. The literature is reviewed and this disease entity is discussed.
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Affiliation(s)
- A J Kirsch
- Department of Urology, State University of New York Health Science Center, Brooklyn
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16
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Martin RW, Rady P, Arany I, Tyring SK. Benign Leydig cell tumor of the testis associated with human papillomavirus type 33 presenting with the sign of Leser-Trélat. J Urol 1993; 150:1246-50. [PMID: 8396689 DOI: 10.1016/s0022-5347(17)35745-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We present a case of a benign testicular Leydig cell tumor and eruptive seborrheic keratosis associated with human papillomavirus type 33 infection. To our knowledge this is the first occurrence of a Leydig cell tumor in a patient with tuberous sclerosis and the second documented case of eruptive seborrheic keratoses (sign of Leser-Trélat) associated with a benign neoplasm.
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Affiliation(s)
- R W Martin
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
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17
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Ahsan Z, Maloney DJ, English PJ. Metastasis to skin from Leydig cell tumour. BRITISH JOURNAL OF UROLOGY 1993; 72:510-1. [PMID: 8261311 DOI: 10.1111/j.1464-410x.1993.tb16189.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Z Ahsan
- Department of Urology, Dryburn Hospital, Durham
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18
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van der Hem KG, Boven E, van Hennik MB, Pinedo HM. Malignant Leydig cell tumor of the testis in complete remission on o,p'-dichlorodiphenyl-dichloroethane. J Urol 1992; 148:1256-9. [PMID: 1404649 DOI: 10.1016/s0022-5347(17)36878-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A 56-year-old patient is described who presented with retroperitoneal lymph node metastases 2 years after resection of a Leydig cell tumor of the left testis. The patient did not suffer from endocrinological imbalance. Surgical removal of the metastases alleviated abdominal symptoms for 1 year. o,p'-Dichlorodiphenyl-dichloroethane (o,p'-DDD) treatment was started at the time of recurrence of the retroperitoneal mass and the appearance of a hepatic metastasis. Tumors were remarkably responsive to o,p'-DDD, since 2 complete remissions could be obtained for extended periods. The o,p'-DDD was tolerated reasonably well and serum levels of 15 to 20 mg./l. were sustained for many months. Unfortunately, the patient could not be cured with this effective treatment.
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Affiliation(s)
- K G van der Hem
- Department of Clinical Oncology, Free University Hospital, Amsterdam, The Netherlands
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19
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Abstract
Malignant Leydig cell tumors (LCT) are rare. Only 32 cases of malignant LCT (as evidenced by metastatic spread) were reported. Generally metastatic spread occurs within 2 years of the primary LCT, and the patient dies within 2 years of the discovery of metastatic disease. The tumor is highly resistant to both radiation and chemotherapy. It also has a great propensity for recurring after surgical resection. A case is reported of a patient whose metastatic disease occurred 8 years after his primary LCT had been resected. He was treated with doxorubicin and mitotane without response. The clinical features of this case are highlighted, and a review of the literature describing treatment of this rare disease is presented.
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Affiliation(s)
- K A Bertram
- Department of Medical Oncology, Madigan Army Medical Center, Tacoma, Washington 98431
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20
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Abstract
Testicular tumors of non-germ cell origin represent from 5 percent to 10 percent of all testicular neoplasms. Included in this group are sex cord/gonadal stromal tumors, most originating from Leydig or Sertoli cells, mixed tumors, and tumors of mesenchymal or hematopoietic origin. In addition, various miscellaneous lesions, tumor-like conditions, and secondary testicular tumors may be classified as non-germ cell tumors. This review covers the presentation, diagnosis, and treatment of these rare lesions.
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Affiliation(s)
- J P Dilworth
- Department of Urology, Mayo Clinic, Rochester, Minnesota
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