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[Leydig cell testicular tumors. A series of 10 observations]
A Kalfon1, F Abram, F Kirsch-Noir
1Service d'Uro-Andrologie, Hôpital Tenon, Paris, France.
Objectives:
To define the clinical and laboratory characteristics and natural history of Leydig cell tumours in order to define a general management plan.
Material And Methods:
The files of 10 patients operated for Leydig cell testicular tumour between 1982 and 1996 were studied retrospectively.
Results:
In nine out of ten cases, the presenting complaint was gynaecomastia, erectile dysfunction or infertility. In every case, serum testosterone was normal or low and oestradiol was normal or elevated. Eight patients were treated by radical orchidectomy, and two by subcapsular orchidectomy. The course was favourable in 9 out of 10 cases in the absence of any other treatment. Only one patient had an immediately malignant form with a fatal outcome.
Conclusion:
Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it is subsequently followed by close surveillance, as it preserves maximum fertility, and these tumours usually have a favourable prognosis.