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Comparative Study
. 2020 Nov;38(11):2857-2862.
doi: 10.1007/s00345-020-03079-1. Epub 2020 Jan 20.

Leydig-cell tumour of the testis: retrospective analysis of clinical and therapeutic features in 204 cases

Christian Guido Ruf #  1   2 , Nojan Sanatgar #  3 , Hendrik Isbarn  4 , Birgit Ruf  5 , Jörg Simon  6 , Christian Daniel Fankhauser  7 , Klaus-Peter Dieckmann  8
Affiliations
Comparative Study

Leydig-cell tumour of the testis: retrospective analysis of clinical and therapeutic features in 204 cases

Christian Guido Ruf et al. World J Urol. 2020 Nov.

Abstract

Purpose: Leydig-cell tumours (LCT) of the testis are poorly understood clinically. The aim of this report is to analyse the clinical characteristics of LCT in a large patient sample and to compare these findings with corresponding data of germ-cell tumours (GCT).

Methods: In a sample of 208 patients treated during 1995-2017 in 33 institutions, the following characteristics were registered: age, presenting symptoms, primary tumour size, testis-sparing surgery (TSS) or orchiectomy, malignancy, laterality, medical history, and outcome. Data analysis included descriptive statistical methods and logistic regression analysis.

Results: The ratio LCT:GCT is 1:23 (4.4%). The findings are as follows: median age 41 years, undescended testis 8%, bilateral LCTs 3%, malignant LCT 2.5%, contralateral GCT 2.5%, incidental detection 28%, scrotal symptoms 43%, infertility 18%, elevated estradiol levels 29%. TSS was performed in 56% with no local relapse. Of the patients with malignant LCT, one was cured through surgery.

Conclusion: LCT is rare, with a relative frequency (relative to GCT) of 1:23. Malignancy is found in 2.5%. LCT and GCT share a number of clinical features, e.g. bilaterality, history of undescended testis, and presenting age. TSS is safe in benign LCT. Surgery is the treatment of choice in malignant LCT.

Keywords: Germ cell tumour; Infertility; Leydig cell tumour; Testicular neoplasm; Testis-sparing surgery.

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