Leydig cell tumor

Causes

The cause of this tumor is unknown. There are no known risk factors for getting this tumor. Unlike germ cell tumors of the testicles, this tumor does not seem to be linked to undescended testes (cryptorchidism).

Leydig cell tumors make up a very small number of all testicular tumors. They are most often found in men between the ages of 20 and 60. This tumor is not common in children before puberty, but it may cause early puberty.

Symptoms

There may be no symptoms.

When symptoms do occur, they can include:

• Discomfort or pain in the testicle
• Enlargement of a testicle or change in the way it feels
• Excess development of breast tissue (gynecomastia) -- however, this can occur normally in adolescent boys who do not have testicular cancer
• Heaviness in the scrotum
• Lump or swelling in either testicle
• Pain in the lower abdomen or back

Symptoms in other parts of the body, such as the lungs, abdomen, pelvis, back, or brain may also occur if the cancer has spread.

Exams and Tests

A physical examination typically reveals a firm lump in one of the testicles. When the health care provider holds a flashlight up to the scrotum, the light does not pass through the lump.

Other tests include:

• Blood tests for tumor markers: alpha fetoprotein (AFP), human chorionic gonadotropin (beta HCG), and lactate dehydrogenase (LDH)
• Chest x-ray
• CT scan of the abdomen and pelvis
• Ultrasound of the scrotum

An examination of the tissue is usually done after the entire testicle is surgically removed (orchiectomy).

Treatment

Treatment of a Leydig cell tumor depends on its stage.

• Stage I cancer has not spread beyond the testicle.
• Stage II cancer has spread to lymph nodes in the abdomen.
• Stage III cancer has spread beyond the lymph nodes (it could have spread as far as the liver, lungs, or brain)

Surgery is done to remove the testicle (orchiectomy), and it may also remove nearby lymph nodes (lymphadenectomy).

Chemotherapy to treat this type of tumor uses drugs such as cisplatin, bleomycin, and etoposide to kill cancer cells. Because Leydig cell tumors are rare, these treatments have not been studied as well as they have for other, more common testicular cancers.

Support Groups

Joining a support group where members share common experiences and problems can often help ease the stress of illness. Your local branch of the American Cancer Society may have a support group. See: www.cancer.org for more information.

The National Cancer Institute website also provides further information: www.cancer.gov.

Outlook (Prognosis)

Testicular cancer is one of the most treatable and curable cancers.

Possible Complications

Testicular cancer may spread to other parts of the body. The most common sites include the:

• Abdomen
• Lungs
• Retroperitoneal area (the area near the kidneys)
• Spine

Complications of surgery can include:

• Bleeding and infection
• Infertility (if both testicles are removed)

If you are of childbearing age, ask your doctor about methods to save your sperm for use at a later date.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of testicular cancer.

Prevention

The United States Preventive Services Task Force does not recommend routine screening for testicular cancer because no screening technique is known to be effective.

However, performing a testicular self-examination (TSE) each month may help detect testicular cancer at an early stage, before it spreads. Finding testicular cancer early is important to successful treatment and survival.

Alternative Names

Tumor - Leydig cell; Testicular tumor

References

Einhorn LH. Testicular cancer. In Goldman L, Schafer AI,eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 206.

National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Testicular cancer. 2012. Version 1.2012.

Update Date: 6/5/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.