Leydig Cell Tumor with Gynecomastia: Further Studies—The Recovery after Unilateral Orchidectomy

Abstract

The recovery of exocrine and endocrine testicular function was studied in six patients orchidectomized for an estrogen-producing Leydig cell tumor. Gynecomastia disappeared in four patients. The contralateral testis, whose volume was reduced, returned to normal size after 30 days. Sperm density returned to normal in only one of the four patients in whom the preoperative sperm count was reduced. One day after unilateral orchidectomy, plasma estradiol decreased to normal and testosterone (T) fell about 50%. On the 10th postoperative day, plasma T [5.60 +/- 1.20 ng/ml (SD)] was normal. On day 120, T was higher than on day 10 (6.83 +/- 1.20 ng/ml). There was no significant increase of T after a single injection of hCG (5000 IU) on day 10, and the T response was similar to that of normal men on day 120. Plasma FSH and LH were increased on the 10th postoperative day; they then decreased between 60 and 120 days after the operation but were still above the normal values on day 120. The FSH/LH ratio, which was 0.43 +/- 0.17 preoperatively returned to normal (1.60 +/- 0.25) 10 days postoperatively. In conclusion, after hemicastration for an estrogen-secreting tumor, testicular hormonal secretion returns to normal within 120 days but spermatogenesis may still be impaired at this time.

Luteinizing hormone secretory pattern before and after removal of Leydig cell tumor of the testis

“…Such data are in agreement with preoperative values already reported in those patients (5,6,9). Such data are in agreement with preoperative values already reported in those patients (5,6,9).…”

Follicle-Stimulating Hormone (FSH) Action on Spermatogenesis: A Focus on Physiological and Therapeutic Roles

“…Similar data were described in men after removal of a testis with malignant cells, where contralateral testicular hypertrophy occurred [45]. In this setting, testicular hormonal secretion and sperm production returned to physiological levels within 120 days after hemicastration, confirming the compensatory increase of spermatogenesis in the remaining testis [45]. These data are corroborated by studies of patients affected by pituitary FSH-secreting adenomas, which showed elevated testicular enlargement likely due to FSH over-stimulation, even when occurring after puberty [50].…”

“…Unilateral orchiectomy results in inhibin B decrease, resulting in endogenous FSH rise and support of sperm production through increased stimulation of B spermatogonia proliferation [49]. Similar data were described in men after removal of a testis with malignant cells, where contralateral testicular hypertrophy occurred [45]. In this setting, testicular hormonal secretion and sperm production returned to physiological levels within 120 days after hemicastration, confirming the compensatory increase of spermatogenesis in the remaining testis [45].…”

“…Information about the physiological role of FSH in spermatogenesis comes from mammalian models of hemicastration, including primates, where a significantly increased volume of the contralateral testis occurs [45][46][47][48][49]. Considering that the adult Sertoli cell numbers do not change, the increase in testicular size is reasonably due to the growing amount of germ cells [49].…”

Use of antibodies against LH receptor, 3beta-hydroxysteroid dehydrogenase and vimentin to characterize different types of testicular tumour in dogs

“…Seminomas have been associated only rarely with feminization. In men, feminization occurs primarily in conjunction with Leydig cell tumours, which is not surprising given that these cells are the main source of oestrogens in human testes (Bercovici et al, 1985;Haas et al, 1989).…”