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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] [What about the content of this article? (0)] [Affiliation(s)] [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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2
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Kwon SC, Yoo DY, Ko M, Lee KY, Kwak HH, Park IC, Hwang IK, Choi JH, Chung JY. Mammary gland tumors in a male Cocker Spaniel. Acta Vet Scand 2017; 59:20. [PMID: 28399884 PMCID: PMC5387325 DOI: 10.1186/s13028-017-0290-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/07/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mammary gland tumors are the most common tumors in sexually intact female dogs; however, they are rare in male dogs. This study was conducted to investigate the relationship between sexual hormones and mammary gland tumors in a male dog. CASE PRESENTATION A 13-year-old, intact male Cocker Spaniel presented to the Veterinary Teaching Hospital of Kangwon National University, Republic of Korea, with an acute right ruptured caudal abdominal mass. Physical examination revealed a 14 × 14 cm ruptured mass in the right caudal abdomen, as well as a 1.5 × 1.5 cm mass in the first right mammary gland. The estrogen and progesterone concentrations in serum were within normal levels. Total mastectomy was done on the right side mammary glands. Following surgery, the site was fully recovered; however, a mass that had grown to 2 × 2 cm was found in the left fifth mammary gland and a testis tumor was also found over the period of 4 months. Mastectomy was performed on the left caudal mammary gland and castration was also performed. After the final surgery, the dog fully recovered. Histopathological examination of all three masses revealed high grade mammary adenocarcinoma in the mammary gland and the testis was diagnosed as Leydig cell adenoma. Immunohistochemical analysis revealed that the estrogen and progesterone receptors were expressed on limited cells in mammary and testis tumors. CONCLUSION The results of this study suggest that mammary tumors and testes tumors can occur in male dogs without relationship to female sexual hormone.
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Affiliation(s)
- Soon-Chan Kwon
- Department of Veterinary Internal Medicine and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
| | - Dae-Young Yoo
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and Research Institute for Veterinary Science, Seoul National University, Seoul, 151-742 Republic of Korea
| | - Minho Ko
- Department of Veterinary Internal Medicine and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
| | - Kwon-Young Lee
- Department of Anatomy, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
| | - Ho-Hyun Kwak
- Department of Veterinary Surgery, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
| | - In-Chul Park
- Department of Veterinary Radiology, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
| | - In-Koo Hwang
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and Research Institute for Veterinary Science, Seoul National University, Seoul, 151-742 Republic of Korea
| | - Jung-Hoon Choi
- Department of Anatomy, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
| | - Jin-Young Chung
- Department of Veterinary Internal Medicine and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon, 200-701 Republic of Korea
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3
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Abstract
We present the clinical findings, diagnosis and treatment of an 11-year old intact male Fox Terrier with a malignant Leydig cell tumor of the right testicle, which metastasized to the skeletal musculature of the left hind limb. The primary tumor and the metastasis were resected with narrow margins. The dog was treated with metronomic chemotherapy using thalidomid and dyclophosphamide. Local recurrence at the site of the metastasis and a pulmonary metastasis were present 30 months after surgery. The dog was euthanized.
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4
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Lai N, Zeng X, Li M, Shu J. Leydig cell tumor with lung metastasis diagnosed by lung biopsy. Int J Clin Exp Pathol 2015; 8:12972-12976. [PMID: 26722493 PMCID: PMC4680438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/28/2015] [Indexed: 06/05/2023]
Abstract
Leydig cell tumors are very rare and account for only 3% of testicular tumors and are generally benign. Only less than 0.2% of all testicular cancers were evidenced by metastatic spread. We report a 34-year-old man visited hospital because of coughing sputum mixed with blood. His chest CT showed bilateral patch clouding opacity. He was suspected with allergic alveolitis and treated with methylprednisolone. However, his symptoms and general condition deteriorated, and he visited our hospital. He had no abnormal findings on physical examination. A chest radiograph showed pneumonia in whole lung and CT showed multiple nodules and diffused ground glass opacities in both lung fields. Lung biopsy confirmed a diagnosis of Leydig cell tumor with lung metastasis. The diagnosis is based on the histopathology and immunohistochemistry.
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Affiliation(s)
- Ning Lai
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The 1st Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong, People's Republic of China
| | - Xin Zeng
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The 1st Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong, People's Republic of China
| | - Meichan Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The 1st Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong, People's Republic of China
| | - Jiaze Shu
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The 1st Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong, People's Republic of China
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5
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Cost NG, Maroni P, Flaig TW. Metastatic relapse after initial clinical stage I testicular Leydig cell tumor. Oncology (Williston Park) 2014; 28:211-214. [PMID: 24855728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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6
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Tiwari P, Goel A, Sharma P, Kumar S, Vijay M, Dutta A. Leydig cell tumor with mediastinal and lung metastasis. Saudi J Kidney Dis Transpl 2011; 22:354-356. [PMID: 21422645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
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7
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Bhat GM, Lone MI, Alsolami S, Iqbal QM. Recurrent malignant Leydig cell tumor of testis: a case report with review of literature. Gulf J Oncolog 2010:42-45. [PMID: 20164008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2009] [Indexed: 05/28/2023]
Abstract
Malignant Testicular Leydig Cell tumors (leydigomas) are extremely rare to occur and mostly carry a bad prognosis. Here we describe the disease course of a middle aged patient with recurrent / metastatic Leydig cell tumor of testes, who needed repeated oncosurgical intervention and chemotherapy.
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Affiliation(s)
- G M Bhat
- Department of Medical Oncology, SKIMS, Soura, Srinagar, Kashmir, India.
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8
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Naik R, Upadhyaya K, Pai MR, Baliga PB, Nayak SK. Fine needle aspiration of metastatic malignant Leydig cell tumor of testis: a case report. INDIAN J PATHOL MICR 2007; 50:624-5. [PMID: 17883165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
A 53-year-old male presented with a right inguinal mass of one-year duration. The fine needle aspiration of the inguinal mass showed a highly cellular tumor composed of sheets and isolated, large round to polygonal cells with moderate pleomorphism. Many bare nuclei were seen with occasional intranuclear inclusions. A provisional diagnosis of metastasis probably of testicular tumour was made. The orchidectomy showed a brown tumor replacing the entire testis and infiltrating the epididymis. The histological features showed Leydig cell tumor without Reinke crystalloids.
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Affiliation(s)
- Ramadas Naik
- Department of Pathology, Kasturba Medical College, Mangalore, Karnataka
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9
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Abstract
Non islet cell tumour hypoglycaemia (NICTH) is a rare cause of hypoglycaemia associated with malignancy and can be considered as a paraneoplastic syndrome. The hormonal factor associated with this condition is big IGF II, which exerts negative feedback effect and decreases the production of growth hormone and insulin. Due to low growth hormone levels, hepatic production of IGFBP 3 (the main binding protein of IGF II) is impaired. Excess free big IGF II is thus available for binding with insulin receptors to cause hypoglycaemia. Treatment options are either surgical removal of the tumour, administration of growth hormone, glucocorticoids or combination of treatments. A case of metastatic Leydig cell tumour causing NICTH has been discussed and the mechanism of NICTH hypoglycaemia and the treatment is outlined.
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Affiliation(s)
- Sagarika Mukherjee
- Department of Diabetes and Endocrinology, University Hospital of Wales, Cardiff, Wales, UK.
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10
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Froehner M, Beuthien-Baumann B, Dittert DD, Schuler U, Wirth MP. Lack of efficacy of imatinib in a patient with metastatic Leydig cell tumor. Cancer Chemother Pharmacol 2006; 58:716-8. [PMID: 16450163 DOI: 10.1007/s00280-005-0181-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Accepted: 12/22/2005] [Indexed: 10/25/2022]
Abstract
Imatinib is a tyrosine kinase inhibitor with activity in gastrointestinal stromal tumor and a variety of other solid and hematological malignancies. Studies in vitro and in a mouse model suggested that the imatinib might also be active in malignant Leydig cell tumor. We report on the--to our knowledge--first treatment experiment with imatinib in a patient with metastatic Leydig cell tumor. Unfortunately, the tumor progressed during treatment.
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Affiliation(s)
- Michael Froehner
- Department of Urology, University Hospital, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
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11
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Lam JS, Borczuk AC, Franklin JR. Metastatic Leydig cell tumor of the testicle in a young African American male. Can J Urol 2003; 10:2074-6. [PMID: 14704114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Malignant Leydig cell tumor (LCT) of the testis are extremely rare and account for less than 0.2% of all testicular cancers. Testicular tumors of all histological types rarely occur in African American men. The authors describe a rare case of an advanced stage malignant LCT arising from the testicle of an African American man at the young age of 35, who presented with hemoptysis and a productive cough. Clinical features and treatment of Leydig cell tumor of the testis are discussed.
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Affiliation(s)
- John S Lam
- Department of Urology, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, NY, USA
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12
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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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13
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Abstract
A case of malignant Leydig cell tumour is presented. It is a rare primary malignant tumour of the testis and occurs exclusively in adults. The present case is of interest because it occurred at the young age of 25 years which is rare. Histologically it showed almost all features which suggest malignancy and also had metastases to the lungs and liver. The clinical details and pathology of this tumour are discussed.
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Affiliation(s)
- Manish Powari
- Postgraduate Institute of Medical Education and Reserach, Chandigarh, India
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14
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Abstract
690 patients were treated for testicular tumour in the course of 18 years. The histology of 7 cases showed Leydig cell tumour. In 4 of the 7 cases, a metastatic process leading to death was observed. At the time of diagnosis, 5 patients were found to have low stage, whereas 2 of the patients had advanced lymphatic involvement. The hematogenous and lymphatic metastases proved to be resistant to chemotherapy. Contrary to the major part of the literature, retroperitoneal lymphadenectomy should be performed with this histological type for the exact pathological staging immediately following orchiectomy.
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Affiliation(s)
- L M Farkas
- Department of Urology, Medical School of Pécs University, Pécs, Hungary
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15
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Papadimitris C, Alevizaki M, Pantazopoulos D, Nakopoulou L, Athanassiades P, Dimopoulos MA. Cushing syndrome as the presenting feature of metastatic Leydig cell tumor of the testis. Urology 2000; 56:153. [PMID: 10869651 DOI: 10.1016/s0090-4295(00)00526-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report a patient with a history of orchiectomy for Leydig cell tumor of the testis who developed Cushing syndrome. This syndrome was due to ectopic production of cortisol and was the primary feature of tumor recurrence.
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Affiliation(s)
- C Papadimitris
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece
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16
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Abstract
Leydig cell tumors of the testis are uncommon. Only about 10% of cases have a malignant course. It has been stated that the only definite criterion for malignancy is presence of metastasis. We present a 47-year-old patient with metastatic Leydig cell tumor 17 years after initial diagnosis, to our knowledge the longest reported interval between diagnosis and the development of metastasis. The primary tumor did not exhibit convincing features of malignancy. The initial metastasis in the right perirenal fat tissue showed a biphasic tumor with sarcomatoid differentiation not described previously in a metastatic Leydig cell tumor.
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Affiliation(s)
- H E Gulbahce
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
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17
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Jiménez López-Lucendo N, Fernández Durán A, Martín García C, Fernández Gómez J, Martín Dávila F. [Malignant Leydig cell tumor. Report of a case and review of the literature]. ARCH ESP UROL 1999; 52:174-7. [PMID: 10218284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To report an additional case of malignant Leydig cell tumor of the testis. The clinical, hormonal and histological criteria for malignancy are analyzed and the different therapeutic options are discussed. METHODS/RESULTS A 75-year-old male presented with a painful testicular tumor, dyspnea and generalized syndrome. The chest film showed multiple bilateral metastatic pulmonary lesions. Pathological analysis disclosed malignant Leydig cell tumor. The patient died one month after orchidectomy due to the neoplasm. CONCLUSIONS Metastatic Leydig cell tumor is uncommon. To date, no available treatment can significantly alter the course of the disease.
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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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20
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Affiliation(s)
- Z Ahsan
- Department of Urology, Dryburn Hospital, Durham
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21
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Abstract
BACKGROUND Testicular germ cell neoplasms occur bilaterally in approximately 2-5% of patients. Bilateral testicular tumors of different histogenesis are extremely rare, and the study of such cases may offer clues to the pathogenesis of both tumor entities. METHODS A report of a case and review of the literature are presented. RESULTS A 33-year-old man had a right-sided testicular neoplasm consisting of teratoma, embryonal carcinoma, and yolk sac tumor. Retroperitoneal lymph node metastases were excised, and, subsequently, adjuvant abdominal radiation therapy was administered. The patient later received six cycles of cisplatin-based chemotherapy for pulmonary relapse. When he was 40 years of age, a contralateral Leydig cell tumor (LCT) was treated by testis-sparing excision. This is the first observation of testicular germ cell tumor (GCT) and contralateral LCT. Three cases of germ cell neoplasm and concurrent ipsilateral LCT have been reported previously. CONCLUSIONS The association of GCT and LCT in one patient is quite unusual because both entities are rare. Sharing of common etiologic factors by both entities is a possible explanation.
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Affiliation(s)
- K P Dieckmann
- Urologische Klinik, Klinikum Steglitz Freie Universität, Berlin, Germany
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22
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Sicard-Rosenbaum L, Danoff J. Cancer and ultrasound: a warning. Phys Ther 1993; 73:404-6. [PMID: 8497517 DOI: 10.1093/ptj/73.6.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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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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24
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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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25
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Kleinhans G, Cohausz G, Dorst KG, Witting C, Neuber A. [Late metastasis of an extragonadal Leydig cell tumor]. Urologe A 1989; 28:231-3. [PMID: 2763398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The case of a 36-year-old patient who underwent extirpation of a Leydig cell tumor of the epididymis is presented. Five years later a retroperitoneal mass was removed, which was found to be a metastatic Leydig cell carcinoma. The literature conrains reports of only 32 cases of metastatic Leydig cell tumors, all of which had originated in the testis and not extragonadally. The symptoms, treatment and prognosis are discussed with reference to the literature.
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Affiliation(s)
- G Kleinhans
- Urologische Klinik, Westfälische Wilhelms-Universität Münster
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26
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Abstract
A patient is described with a hormone-secreting interstitial cell tumor, manifesting metastasis 7 years after removal of a reportedly benign primary tumor. The late course of the disease was followed by computerized tomography and serum hormone assays. Previously reported cases of metastatic interstitial cell tumor are reviewed, and prognostic features and treatment are discussed.
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Affiliation(s)
- M I Schwarzman
- Department of Surgery (Urology Service), Memorial Sloan-Kettering Cancer Center, New York, New York 10021
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27
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Kapoor HL, Seam RK, Sharma S, Sharma RD. Malignant interstitial cell tumour of testis in a child. Indian J Cancer 1988; 25:241-5. [PMID: 3243573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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28
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Abstract
Paraneoplastic erythrocytosis associated with production of erythropoietin and testosterone by a malignant lipid cell tumor is demonstrated in this case report. Several chemotherapeutic regimens failed to halt the progression of this aggressive metastatic lipid cell tumor. The scant literature on malignant lipid cell tumors is reviewed. Possible mechanisms for paraneoplastic erythrocytosis are presented. Adequate control of polycythemia preoperatively will reduce thromboembolic and hemorrhagic complications.
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29
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Cervenakov I, Lepies P, Mardiak J, Ondrus B, Durcany V. Malignant Leydig-cell tumour of testis. Int Urol Nephrol 1984; 16:227-32. [PMID: 6480283 DOI: 10.1007/bf02082567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A rare case of a malignant Leydig-cell tumour of the testis in a 26-year-old patient, with radical orchiectomy from an inguinal incision is described. Although the results of AFP, HCG, biochemical, X-ray, lymphographic and scintigraphic examinations were negative, the first metastases into the lungs appeared one year after the operation. Combined cytostatic treatment, polychemotherapy and X-ray therapy proved ineffective. The patient died of multiple metastases 28 months after the surgical intervention.
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30
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Lämmli J, Bühler H, Bosseckert H, Capitaine Y, Deyhle P, Eichenberger P, De Peyer R, Rösch W. [Metastases to the duodenum]. Schweiz Rundsch Med Prax 1982; 71:1054-7. [PMID: 7122401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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31
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Pride GL, Pollock WJ, Norgard MJ. Metastatic Sertoli-Leydig cell tumor of the ovary during pregnancy treated by BV-CAP chemotherapy. Am J Obstet Gynecol 1982; 143:231-3. [PMID: 6177244 DOI: 10.1016/0002-9378(82)90664-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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32
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Behrendt H, Brehmer B, Hossfeld DK. [The diagnostic and therapeutic value of second look operation in patients with testicular germinal cell tumors (author's transl)]. Urologe A 1981; 20:231-3. [PMID: 7196634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We report on 32 patients with testicular tumor who--after earlier retroperitoneal lymph node dissection--underwent a second-look operation. Whereas in 16 patients vital tumor tissue was found in the retroperitoneum 9 patients had only degenerative changes with fibrosis and necrosis. In 7 patients the retroperitoneum showed no evidence of disease. It is our conclusion that an extensive pre-operative diagnostic workup, including tumor-markers, ultrasound and CT in patients treated with chemo- and radiotherapy cannot determine whether viable tumor tissue is present in the retroperitoneum. In 13 patients with non-seminomatous germinal cell tumors where viable tumor tissue was found at second-look operation 61,5% had normal tumor-markers. Those patients in whom at second-look operation no viable tumor tissue was found benefit from that approach because of the possibility of terminating aggressive chemotherapy. On the other hand patients with vital tumor tissue had a poor prognosis.
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Knyrim K, Higi M, Hossfeld DK, Seeber S, Schmidt CG. Autonomous cortisol secretion by a metastatic Leydig cell carcinoma associated with Klinefelter's syndrome. J Cancer Res Clin Oncol 1981; 100:85-93. [PMID: 7016888 DOI: 10.1007/bf00405905] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We present the case of a 39-year-old man with Klinefelter's syndrome and a metastatic Leydig cell carcinoma in whom autonomous cortisol production induced by the interstitial cell tumor was found. Apart from the Cushing's syndrome the endocrine activity of the tumor was demonstrated by the secretion of estradiol, estrone, alkaline phosphatase, and testosterone. This is, to our knowledge, the first description of a Cushing's syndrome not caused via ACTH production but directly induced by ectopic steroid production. While being resistent to chemotherapy and radiation, the tumor responded favorably to treatment with o,p'-DDD. The reduction of tumor size was accompanied by a continuous decrease of serum markers. The etiology of the tumor is discussed in the light of the hormonal derangement caused by the genetic abnormality of Klinefelter's syndrome.
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