Malignant interstitial cell tumor of the testis

Abstract

A case of malignant interstitial cell tumor of the testis in man and a review of the literature is presented. This is a rare steroid‐producing tumor; a careful search revealed only 9 published cases. The inadequacy of radiotherapy in management of the disease is dramatically demonstrated. (Periaortic nodes containing metastatic cancer were identified in retroperitoneal areas previously exposed to intensive cobalt therapy.) This lack of radiosensitivity leads to a plea for the use of a radical surgical attack as initial therapy. Illustrations of the comfortable and extensive exposure for a retroperitoneal node dissection using the Nagamatsu approach and technique are presented. Particular interest is aroused by this tumor because its endocrine activity so closely resembles that of cancer of the adrenal cortex. The hormonal disturbances such as gynecomastia and elevated testosterone levels are discussed, as well as the use of OP1‐DDD as a chemotherapeutic agent.

Treatment of malignant leydig cell tumor

“…Unfortunately, this did not prevent recurrence of his disease: 3 years later, he had, not only a local recurrence, but also metastatic disease in the previous radiation ports. 26 Surgery also was used to treat metastatic LCT, and there are two reports of successful treatment in the literature, although one had a follow-up time of only 6 months. In 1958 a case was reported of a 45-year-old man with a left lower pulmonary nodule, which on wedge resection, had a similar histologic appearance to a LCT resected 8 years previously.…”

“…Although there was some decrease in his supraclavicular mass, there was no appreciable effect elsewhere on his widely metastatic tumor. 26 Others used the drug in two patients who previously had no effect from two different combination chemotherapy regimens, but neither responded." The drug also was used in a patient with unresectable retroperitoneal disease, without any benefit.I6 Another patient was treated with mitotane without any effect.…”

Spinal cord compression by a solitary metastasis from a low grade leydig cell tumour: a case report and review of the literature

“…Traditionally, spinal metastases treatment involves radiation therapy, either alone or in conjunction with chemotherapy and/or surgical decompression. "Prophylactic" irradiation had not prevented local recurrence or metastatic spread within the radiation ports [ 15 ]. Several chemotherapeutic agents have been used in the treatment of metastatic Leydig cell tumour, with uniformly poor results [ 4 , 5 , 12 ].…”

“…The natural course of patients with metastatic variety of Leydig cell tumour is one of progression at an unpredictable pace. The median survival of these patients with metastatic disease is less than 2 years [ 4 , 11 - 15 ].…”