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Leydig cell tumor

A Leydig cell tumor is a tumor of the testicle. It develops from Leydig cells. These are the cells in the testicles that release the male hormone, testosterone.

Causes

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

Leydig cell tumors make up a very small number of all testicular tumors. They are most often found in men between 30 and 60 years of age. 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 growth 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
  • Not able to father children (infertility)

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. This test is called transillumination.

Other tests include:

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 (possibly as far as the liver, lungs, or brain).

Surgery is done to remove the testicle (orchiectomy). Nearby lymph nodes may also be removed (lymphadenectomy).

Chemotherapy may be used to treat this tumor. As Leydig cell tumors are rare, these treatments have not been studied as much as treatments 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.

Outlook (Prognosis)

Testicular cancer is one of the most treatable and curable cancers. Outlook is worse if the tumor is not found early.

Possible Complications

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

  • Abdomen
  • Lungs
  • Retroperitoneal area (the area near the kidneys behind the other organs in the belly area)
  • Spine

Complications of surgery can include:

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

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

When to Contact a Medical Professional

Call your provider if you have symptoms of testicular cancer.

Prevention

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

Alternative Names

Tumor - Leydig cell; Testicular tumor - Leydig; Testicular neoplasm

References

American Cancer Society. Do I have testicular cancer? Updated May 23, 2016. www.cancer.org/cancer/testicularcancer/moreinformation/doihavetesticularcancer/do-i-have-testicular-cancer-self-exam. Accessed July 8, 2016.

Friedlander TW, Ryan CJ, Small EJ, Torti F. Testicular cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 86.

National Cancer Institute. PDQ testicular cancer treatment. Updated February 17, 2016. www.cancer.gov/types/testicular/hp/testicular-treatment-pdq. Accessed July 8, 2016.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines): testicular cancer. Version 2. 2016. www.nccn.org/professionals/physician_gls/pdf/testicular.pdf. Accessed July 8, 2016.

Stephenson AJ, Gilligan TD. Neoplasms of the testis. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 34.

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Review Date 5/20/2016

Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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