Malignant Leydig Cell Tumor of the Testis in Complete Remission on o, p′-Dichlorodiphenyl-Dichloroethane

Hem, K.G. van der; Boven, E.; Hennik, M.B. van; Pinedo, H.M.

doi:10.1016/s0022-5347(17)36878-7

Cited by 14 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Azer and Braunstein ( 17 ) used mitotane to treat a patient with metastatic LCT for six months, resulting in a dramatic response with complete remission of multiple pulmonary metastases, which lasted three months prior to relapse. Radiological reduction in tumor load for several months was observed in two cases ( 18 , 19 ). Abelson and coworkers ( 20 ) noted a significant reduction in 17-ketosteroid excretion and clinical improvement in a metastatic LCT patient treated with mitotane for 18 months, while his disseminated metastases progressed.…”

Section: Discussionmentioning

confidence: 96%

“…Clinical improvement with mitotane Complete disappearance of pulmonary metastasis and clinical improvement after 14 weeks on mitotane. 3 months later pulmonary metastasis reappeared, mitotane was stopped and chemotherapy commenced ( 20 ) 58 18 months 10 g initially, then 4–6 g/day (not done) Dexamethasone 0.375 mg twice daily Increased urinary 17-KS and estrogens Died after clinical and biochemical improvement with mitotane but radiological progression Believed to be clinically improving, with reduction in urinary 17-ketosteroids from 1462 to 100 mg/day ( 19 ) 56 6 months + 27 months (9 months break in between) 4–10 g/day (15–20 mg/L) Cortisone acetate, no dose recorded Normal urinary 17OHCS, An, Et, DHEA; normal serum T and DHEAS Died – metastatic disease stabilized for 18 months on mitotane treatment before disease slowly deteriorated Decrease in retroperitoneal tumor, liver lesions, ascites along with stable disease for 18 months. Once disease deteriorated mitotane dose was escalated to 10 g/day with no effect …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mitotane treatment in patients with metastatic testicular Leydig cell tumor associated with severe androgen excess

Chortis¹,

Johal

Bancos

et al. 2018

European Journal of Endocrinology

View full text Add to dashboard Cite

Mitotane (o,p′DDD) is established in the adjuvant and advanced-stage treatment of adrenocortical carcinoma and counteracts both tumor growth and tumor-related steroid production. Both the adrenal glands and the gonads are steroidogenically active organs and share a common embryogenic origin. Here, we describe the effects of mitotane in two patients with metastatic Leydig cell tumor (LCT) of the testes and associated severe androgen excess (serum testosterone 93 and 88 nmol/L, respectively; male reference range 7–27 nmol/L). Both men suffered from severe restlessness, insomnia and irritability, which they described as intolerable and disrupting normal life activities. Urinary steroid profiling by gas chromatography–mass spectrometry (GC–MS) confirmed excess androgen production and revealed concurrent overproduction of glucocorticoids and glucocorticoid precursors, which under physiological conditions are produced only by the adrenal glands but not by the gonads. In a palliative approach, they were commenced on mitotane, which achieved swift control of the hormone excess and the debilitating clinical symptoms, restoring normal quality of life. GC–MS demonstrated normalization of steroid production and decreased 5α-reductase activity, resulting in decreased androgen activation, and imaging demonstrated disease stabilization for 4–10 months. In conclusion, mitotane can be highly effective in controlling steroid excess in metastatic LCTs, with anti-tumor activity in some cases.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Mitotane treatment in patients with metastatic testicular Leydig cell tumor associated with severe androgen excess

Chortis¹,

Johal

Bancos

et al. 2018

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…It is generally recognized that, with only anecdotal exceptions [2] , chemotherapy has no effect on LCT [3,4] . Mitotane (o,p'-DDD), a drug used in the treatment of adrenal tumors, was given to patients with metastatic LCT with only temporary results [30] . Radiotherapy has only symptomatic benefits [3,4] .…”

Section: Discussionmentioning

confidence: 99%

Lessons from 52 Patients with Leydig Cell Tumor of the Testis: The GUONE (North-Eastern Uro-Oncological Group, Italy) Experience

Tonno

Tavolini

Belmonte³

et al. 2009

Urol Int

View full text Add to dashboard Cite

Introduction: The goal of the study was to define treatment rules for the uncommon, rarely (10%) malignant and chemorefractory Leydig cell tumors (LCT) of the testis. Methods: The main clinical data of patients treated in centers affiliated to the GUONE (North-Eastern Uro-Oncological Group, Italy) were reviewed. We considered 52 patients (54 tumors, 2 bilateral) whose ages ranged from 13 to 70 years (mean 36). Of the treatments performed, 52 were orchiectomies and 2 were enucleations (unfavorable pathology in only 2 tumors). There were 5 lymphadenectomies (retroperitoneal lymph node dissections): 2 for suspected stage II disease and 1 each for unfavorable pathology, bilateral disease and associated Sertoli tumor (pathology: pN0 in all cases). The length of follow-up ranged from 15 to 249 months (mean 81). Results: There was no relapse in 51 patients and 1 died as a result of metastatic disease (orchiectomy at the age of 70; unremarkable pathology). Conclusions: Malignant LCT seems to be, in our experience, less frequent than previously reported. Age and pathology are useful prognostic factors, but their predictive value should never be considered absolute. Enucleation seems justified in young patients with favorable pathology. In clinical stage I LCT, retroperitoneal lymph node dissection should be offered to older patients and/or to patients with unfavorable pathology. A prolonged follow-up is mandatory.

show abstract

“…On the other hand, van der Hem et al . reported a patient with a metastatic Leydig cell tumor who had a remarkable response to o,p′‐DDD and was alive for 3 years after the recurrence of the primary tumor 4 . Based on these findings, the efficacy of o,p′‐DDD for advanced Leydig cell tumors is still controversial.…”

Section: Discussionmentioning

confidence: 99%

Elevated serum estradiol suggesting recurrence of Leydig cell tumor nine years after radical orchiectomy

et al. 2002

View full text Add to dashboard Cite

We report a case of a Leydig cell tumor that showed retroperitoneal lymph node metastasis 9 years after radical orchiectomy. Elevated serum estradiol (E2) suggested recurrence of the Leydig cell tumor. Retroperitoneal lymph node dissection (RPLND) was performed and the lymph node was proved histopathologically to have a metastatic Leydig cell tumor. After RPLND, serum E2 returned to the normal range. This is the first reported case in which changes in the endocrinological findings were useful as likely tumor markers to detect the recurrence of a Leydig cell tumor.

show abstract

Malignant Leydig Cell Tumor of the Testis in Complete Remission on o, p′-Dichlorodiphenyl-Dichloroethane

Cited by 14 publications

References 12 publications

Mitotane treatment in patients with metastatic testicular Leydig cell tumor associated with severe androgen excess

Mitotane treatment in patients with metastatic testicular Leydig cell tumor associated with severe androgen excess

Lessons from 52 Patients with Leydig Cell Tumor of the Testis: The GUONE (North-Eastern Uro-Oncological Group, Italy) Experience

Elevated serum estradiol suggesting recurrence of Leydig cell tumor nine years after radical orchiectomy

Contact Info

Product

Resources

About