Presentation
Presentation Most testicular germ cell tumors present with progressive, painless enlargement of the testis. They may grow slowly or with appalling speed. Sometimes, the initial presentation is in the form of a metastatic deposit in the retroperitoneum [slideshare.net]
The malignant yolk sac tumor presents at a median age of 16 months, and teratomas and Sertoli cell tumors present at median ages of 13 months and 6 months, respectively. 1 It is highly unusual for Leydig cell tumors to present prior to 2 years of age. [appliedradiology.com]
The case of benign LCT presented with infertility and was found to have azoospermia. [ijpmonline.org]
Clinical presentation Nearly all testis tumors present with a painless scrotal mass that is usually palpable and seen on ultrasound. However, some may present with signs of hormone production such as early-onset of puberty and/or enlarging breasts. [otstregistry.org]
However, up to 20 % of the patients with sex cord-stromal tumors present with distant metastasis at the time of presentation. Like germ cell tumors, sex cord-stromal tumors are usually seen in young adults. [lecturio.com]
Entire Body System
- Infertility
The case of benign LCT presented with infertility and was found to have azoospermia. [ijpmonline.org]
[…] history of primary infertility. [hormones.gr]
The most common sites include the: Abdomen Lungs Retroperitoneal area (the area near the kidneys behind the other organs in the belly area) Spine Complications of surgery can include: Bleeding and infection Infertility (if both testicles are removed) [medlineplus.gov]
The patient revealed that he was married for 23 years and had primary infertility for which he received no treatment. [sjkdt.org]
Following are complications that may arise from Leydig Cell Tumor of the Testis: Infertility Retrograde ejaculation Excessive blood loss In case of malignant tumors, metastasis and the loss of function of the organ/area to which the cancer spreads Recurrence [dovemed.com]
- Precocious Puberty
Tumor cells may produce androgen, estrogens or both and presents with gynecomastia or precocious puberty; symptoms usually regress with excision. Gross: Golden-brown to yellow or gray-white cut surface (ave. 3 cm) (image A). [auanet.org]
Children typically present with precocious puberty. Due to excess testosterone secreted by the tumour, one-third of female patients present with a recent history of progressive masculinization. [en.wikipedia.org]
puberty in boys Physical exam solid mass of the testes is always cancer Prognosis Seminoma late metastasis and excellent prognosis Embryonal worse prognosis than seminoma Choriocarcinoma worst prognosis in contrast to good prognosis in females metastasizes [medbullets.com]
Kirsh AJ, Bastian W, Cohen HL, Glassberg KI, 1993 Precocious puberty in a child with unilateral Leydig cell tumor of the testis following orchidopexy. J Urol 150: 1483-1485. 12. [hormones.gr]
Rare extratesticular sites include, the spermatic cord, adrenal glands, and ovaries. [1] LCTs in pre-pubertal boys present with symptoms of precocious puberty, gynecomastia, and feminization depending on the hormones elaborated. [indianjcancer.com]
- Asymptomatic
Adults are usually asymptomatic, although gynecomastia may be present in 20-25%. Ten percent of tumors in adults are malignant. Laboratory findings include elevated serum and urinary 17-ketosteroids as well as estrogens. [health.am]
Men between 30 and 60 years are asymptomatic or may present with loss of libido, erectile dysfunction, impotence, and infertility. [indianjcancer.com]
If it is secreting androgens the tumour is usually asymptomatic, but can cause precocious puberty in pre-pubertal boys. If the tumour secretes oestrogens it can cause feminisation in young boys. [en.wikipedia.org]
Prevalence of testicular microlithiasis in an asymptomatic population. Scandinavian J Urol Nephrol 2006; 40 : 212. [pediatricurologybook.com]
Men usually present with either an asymptomatic mass or with endocrine abnormalities such as gynecomastia (20-40%) or loss of libido. [ijpmonline.org]
- Weakness
AFP is negative and cytokeratins are negative or weak. [path.upmc.edu]
[…] cancers are not as dangerous as germ cell cancers, because they are not as likely to spread or metastasize The cause of Leydig Cell Tumor of the Testis (a testicular cancer type) is generally unknown, although several risk factors, such as family history, weak [dovemed.com]
- Short Stature
[…] disability-facial dysmorphism syndrome Tall stature-intellectual disability-renal anomalies syndrome Tall stature-scoliosis-macrodactyly of the great toes syndrome Tall stature-scoliosis-macrodactyly of the halluces syndrome Talo-patello-scaphoid osteolysis [orpha.net]
Urogenital
- Testicular Swelling
Adults with Leydig cell tumors typically present with testicular swelling, but decreased libido (20%) and gynecomastia (15-30%) are also common symptoms (1-3). Pseudoprecocity is usually seen in children. [path.upmc.edu]
Serum testosterone level is high. [ citation needed ] In men, testicular swelling is the most common presenting feature. Other symptoms depend on age and the type of tumour. [en.wikipedia.org]
On examination, a testicular swelling was found, and after orchidectomy, he was diagnosed to have malignant LCT on histopathologic examination. [ijpmonline.org]
- Testicular Pain
Patients with Leydig cell tumors might develop testicular pain due to hematoma. Patients with Sertoli cell tumors might present with excess estrogen production and gynecomastia as already explained. [lecturio.com]
The signs and symptoms may include: Loss of libido Overdevelopment of breasts in males (gynecomastia) Breast pain, especially if accompanied by enlargement Trouble breathing Headache Low blood pressure Anemia Testicular pain, lump in the testes, feeling [dovemed.com]
CASE REPORT: A 40 years old man come to our attention for a balanoposthitis without testicular pain. During andrological examination we performed palpation of the testes and we noticed a palpable nodule of hard consistency in the left testicle. [cancerindex.org]
- Painless Testicular Mass
Comprises 1-3% testicular tumors. 2 age peaks: 5-10 years old and 30-35 years old. A few are seen in cryptorchidism. Presents a painless testicular mass. [auanet.org]
Most common germ cell tumor Mean age is 40 yrs Very rare in children Patients present with painless testicular mass 30 % have metastases at presentation, but only 3% have symptoms related to metastases. 11. [slideshare.net]
Workup
Review Topic QID: 106375 5 No further workup, instruct patient to return if symptomatic M1 Select Answer to see Preferred Response PREFERRED RESPONSE 2 Sorry, this question is for PEAK Premium Subscribers only ARTICLES (4) VIDEOS (1) Topic COMMENTS (12 [medbullets.com]
CT scanning of the abdomen and chest radiography: Indicated if malignancy is suspected See Workup for more detail. Management Radical orchiectomy was once the primary treatment for Leydig cell tumors, and it remains in use for malignant cases. [emedicine.medscape.com]
Treatment
As Leydig cell tumors are rare, these treatments have not been studied as much as treatments for other, more common testicular cancers. [medlineplus.gov]
Treatment & Prognosis Radical orchiectomy is the initial treatment for Leydig cell tumors. [health.am]
Treatment Stage I Testicular Cancer Treatment depends on what the cancer cells look like under a microscope (cell type). [washington.edu]
Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. [books.google.es]
The necessity and choice of adjuvant treatment depends on tumor pathology, staging, and prognosis. Treatment options include active surveillance, retroperitoneal radiotherapy, retroperitoneal lymph node dissection, and platinum -based chemotherapy. [amboss.com]
Prognosis
Seminoma late metastasis and excellent prognosis Embryonal worse prognosis than seminoma Choriocarcinoma worst prognosis in contrast to good prognosis in females metastasizes to lungs Please rate topic. [medbullets.com]
The overall prognosis of testicular tumors is excellent; patients can often be cured even in advanced, metastatic stages. [amboss.com]
Typically, in a vast majority of cases, the prognosis is excellent, since it is usually a benign tumor In rare case of a malignancy, the prognosis may depend upon several factors including the stage of the tumor and health status of the individual Generally [dovemed.com]
The prognosis for well-differentiated liposarcoma remains good, with overall 5- and 10-year survivals of 75 and 55%, respectively. The high relapse rate and metastasis observed in high-grade liposarcoma worsen the prognosis significantly. [wcrj.net]
Etiology
Etiology and Pathophysiology of Sex Cord-Stromal Tumors of the Testis Image : “Adolescent with Gynecomastia.” by David Andrew Copeland, Dr. Mordcai Blau www.gynecomastia-md.com – Own work. [lecturio.com]
Etiology Risk factors Cryptorchidism (increased risk for germ cell tumors ) [4] Contralateral testicular cancer Germ cell neoplasia in situ (GCNIS) Family history of testicular cancer Klinefelter syndrome, Down syndrome (increased risk for germ cell tumors [amboss.com]
(Etiology) The cause of Leydig Cell Tumor of the Testis is unknown. [dovemed.com]
[…] are malignant Sites Origin from testis is demonstrable in most cases Rarely originates from epididymis ( Andrologia 2013;45:430 ) Pathophysiology Produce testosterone, dehydroepiandrosterone and androstenedione, which cause symptoms described below Etiology [pathologyoutlines.com]
The etiology of Leydig cell tumors remains unknown. Unlike germ cell testicular tumors, Leydig cell neoplasms are not associated with cryptorchidism. It is thought that an endocrine role may contribute to the development of these tumors. [emedicine.medscape.com]
Epidemiology
Leydig Cell Tumors Epidemiology & Pathology Leydig cell tumors are the most common non-germ cell tumors of the testis and account for 1-3% of all testicular tumors. [health.am]
[…] more common in Hispanics compared to Asian and black populations in the US References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Introduction Testicular tumors can be of germ cell or non-germ cell origin germ cell origin are the majority (95%) and are more commonly malignant non-germ cell origin usually benign Epidemiology incidence most common cancer in men between 15-35 years [medbullets.com]
Epidemiology Leydig cell tumours constitute 1-3% of all testicular tumours. Clinical features In children, they may present with isosexual pseudoprecocity. In adults, they present with a mass and/or gynaecomastia. [e-immunohistochemistry.info]
Epidemiology of Sex Cord-Stromal Tumors of the Testis Sex cord-stromal tumors of the testis can be considered as the rarest form of testicular tumors. The most common form of testicular cancer is germ cell tumors. [lecturio.com]
Pathophysiology
^ a b "Leydig Cell Tumors: Practice Essentials, Background, Pathophysiology". 2016-10-27. ^ Biegel, L. B.; Liu, R. C.; Hurtt, M. E.; Cook, J. C. (1995). [en.wikipedia.org]
Etiology and Pathophysiology of Sex Cord-Stromal Tumors of the Testis Image : “Adolescent with Gynecomastia.” by David Andrew Copeland, Dr. Mordcai Blau www.gynecomastia-md.com – Own work. [lecturio.com]
Epidemiology : usually develop after the age of 4 Pathophysiology : produces ↑↑ amounts of testosterone and a small amount of estrogen, progesterone, and corticosteroids → testosterone excess causes precocious puberty in males (and masculinization in [amboss.com]
[…] and evolution of Leydig cells Epidemiology 1 - 3% of testicular tumors No predilection based on ethnicity or race ~10% are malignant Sites Origin from testis is demonstrable in most cases Rarely originates from epididymis ( Andrologia 2013;45:430 ) Pathophysiology [pathologyoutlines.com]
Background Pathophysiology A German anatomist, Franz Leydig, first described Leydig cells in 1870. [9] Leydig cells are located within the interstitium of the testis, between the seminiferous tubules, and produce testosterone in response to luteinizing [emedicine.medscape.com]
Prevention
We suggest organ-sparing surgery as an alternative in the treatment of bilateral Leydig cell tumors especially for young males, since this surgical approach prevents hormonal replacement therapy and maintains fertility and potency. © 2003 S. [karger.com]
Removal of the testis Debulking surgery to reduce tumor size, followed by chemotherapy Clotting the vessels in the tumor (embolization) Chemotherapy Radiotherapy Undertaking treatment of underlying conditions How can Leydig Cell Tumor of the Testis be Prevented [dovemed.com]
The concept of treating a disease or Krakheit in a preferred embodiment also includes the prevention of this disease or disorder. [google.ga]
Recurrence may be prevented with a modified nerve-sparing RPLND or 2 cycles of platinum-based chemotherapy, but this “over-treats” the 70-75% of patients who do not have occult metastatic disease. [pediatricurologybook.com]
Testicular Cancer Cancer Council NSW Detailed information about testicular cancer, diagnosis, symptoms, treatment, risk, prevention and research. [cancerindex.org]