Leydig cell tumors
Leydig cell tumors are rare tumors that primarily occur in the testicles, arising from Leydig cells responsible for testosterone production. While most Leydig cell tumors are benign, a small percentage can be malignant. These tumors are more common in men aged 30 to 60 but can also affect prepubescent boys and occasionally women, where they may develop in the ovaries. Symptoms can vary; boys may experience early puberty signs, including breast tenderness, while men might face erectile dysfunction and infertility. Women with Leydig cell tumors may exhibit masculine traits due to hormonal changes. Diagnosis typically involves physical examination, ultrasound, and blood tests to measure hormone levels. Treatment usually consists of surgical removal of the tumor, and prognosis is generally favorable for benign cases. However, malignant tumors have a more challenging outcome, with a notably lower survival rate. Understanding Leydig cell tumors is essential for recognizing their potential impacts and treatment options.
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Leydig cell tumors
ALSO KNOWN AS: Testicular tumors, interstitial cell tumors
RELATED CONDITIONS: Sertoli-Leydig cell tumors
DEFINITION: Leydig cell tumors are a rare type of testicular (or, rarely, ovarian) tumor. They arise from the Leydig cells, which produce testosterone and other male hormones in the testicles. Most often, these tumors are benign, but they can sometimes be cancerous.
Risk factors: There are no known risks for this condition; however, it is much more common in men than women.
Etiology and the disease process: The cause of Leydig cell tumors is unknown, but animal studies have suggested that these tumors may grow following exposure to the female hormone estrogen. Leydig cell tumors secrete testosterone and sometimes estrogen. The endocrine system may also play a role, as well as mutations in the luteinizing hormone receptor gene.
Incidence: This condition is most common in men between the ages of thirty and sixty, although it can occur in prepubescent boys and women (in the ovaries). Only between 3 and 22 percent of all testicular tumors are Leydig cell tumors. In about 3 to 10 percent of men who develop Leydig cell tumors, the tumors are found in both testicles. Only about 10 percent of Leydig cell tumors are cancerous.
Symptoms: Boys who develop Leydig cell tumors can develop feminine symptoms such as breast tenderness or nipple soreness, and they often go into early puberty. In men, the symptoms more commonly include erectile dysfunction, decreased sexual drive, and infertility. Women with Leydig cell tumors may develop masculine characteristics, such as excessive hair growth and increased muscle mass.
Screening and diagnosis: The doctor will feel the testicles to check for an enlarged mass. An ultrasound can confirm the diagnosis. Blood tests can be used to identify elevated testosterone and estrogen levels. Liver function tests are sometimes performed on patients who have cancerous Leydig cell tumors.
Treatment and therapy: Most Leydig cell tumors can be treated with surgery to remove the tumor. Radical orchiectomy removes the entire testicle, but testes-sparing surgery may also be an option. Retroperitoneal lymph node dissection may be used for tumors that do not respond to chemotherapy and radiation. Leydig cell tumors can be treated with surgery, but they do not tend to respond well to or radiation.
Prognosis, prevention, and outcomes: The prognosis for people with Leydig cell tumors is excellent because surgery can usually treat the problem. However, those with malignant tumors have an average survival rate of only two years.
Bibliography
Bremmer, F., et al. "Switch of Cadherin Expression as a Diagnostic Tool for Leydig Cell Tumours." APMIS, 121.10, 2013, pp. 976–81.
Gersten, Todd. “Leydig Cell Testicular Tumor.” MedlinePlus, 29 Apr. 2022, medlineplus.gov/ency/article/000409.htm. Accessed 21 June 2024.
Leonhartsberger, Nicolai, et al. "Increased Incidence of Leydig Cell Tumours of the Testis in the Era of Improved Imaging Techniques." BJU International, vol. 108.10, 2011, pp. 1603–7.
Payne, Anita H., and Matthew Phillip Hardy. The Leydig Cell in Health and Disease. Totowa: Humana, 2007.
Pomajzl, AJ. “Leydig Cell Cancer - StatPearls.” NCBI, 4 July 2023, www.ncbi.nlm.nih.gov/books/NBK549800. Accessed 21 June 2024.
“Testicular Cancer - Testicular Tumor.” American Cancer Society, www.cancer.org/cancer/types/testicular-cancer.html. Accessed 21 June 2024.