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Mitotane Treatment for Malignant Leydig Cell Tumor: A Case Report
Daiki Katsura1, Mototsugu Muramaki2, Takashi Okamoto2
1Department of Urology Kobe University Graduate School of Medicine Kobe Japan.
IJU Case Reports
|September 5, 2025
Summary
Malignant Leydig cell tumors (LCTs) are rare, but mitotane showed a notable response in a patient with advanced LCT. Careful management of side effects is crucial for this promising treatment.
Area of Science:
- Oncology
- Endocrinology
- Medical Case Reports
Background:
- Leydig cell tumors (LCTs) are rare testicular neoplasms, typically benign.
- Malignant LCTs pose significant therapeutic challenges due to limited effective treatments.
Purpose of the Study:
- To report a case of malignant Leydig cell tumor with a significant response to mitotane therapy.
- To evaluate the potential of mitotane in managing advanced or metastatic LCTs.
Main Methods:
- Case presentation of a 43-year-old male diagnosed with Leydig cell tumor.
- Initiation of BEP chemotherapy followed by mitotane treatment for metastatic disease.
- Monitoring of treatment response and adverse effects.
Main Results:
- The patient exhibited a marked reduction in liver and lymph node metastases after initiating mitotane.
- Mitotane treatment was discontinued due to adverse effects including fatigue, anorexia, and nipple discomfort.
- Disease progression occurred after mitotane discontinuation, leading to patient death 4 years post-diagnosis.
Conclusions:
- Mitotane demonstrates potential efficacy in treating malignant Leydig cell tumors.
- Management of mitotane's adverse effects is essential for successful therapeutic application.
- Further research is warranted to optimize mitotane use in LCT management.
