Long-Term Followup After Elective Testis Sparing Surgery for Leydig Cell Tumors: A Single Center Experience

Abstract

In patients with Leydig cell tumors testis sparing surgery with frozen section examination provides an excellent long-term oncological outcome.

A contemporary population-based study of testicular sex cord stromal tumours: Presentation, treatment patterns, and predictors of outcome

“…15 Prior single institution experiences suggest the majority of SCST are benign and rarely progress. 3,16 Conversely, the minority of patients that do present with metastatic disease have a poor prognosis. 7,8,17 In our series, patients with metastatic SCST at presentation have a two-year CSS of 30%, compared to a two-year CSS of 95% in those presenting with stage I disease.…”

“…Current knowledge is derived from single-institution experiences and small retrospective case series. Individual case reports have suggested that SCSTs exhibit a benign course and rarely recur, indicating that surgical treatment with orchiectomy alone will cure majority of these tumours; [3][4][5][6] however, in a minority of cases, metastatic disease is found at the time of diagnosis. The prognosis for these individuals is poor.…”

“…1,9 Other studies have reported higher rates of metastatic disease, with Bertram et al reporting a 20% rate of metastatic disease at the time of diagnosis and a 40% risk of metastatic involvement within two years of diagnosis. 10 Furthermore, malignant SCSTs have been reported to respond poorly to conventional radiotherapy and cytotoxic Lindsay M. Yuh, MD 1,5 ; Primo N. Lara Jr, MD 2,5 ; Rebecca M. Wagenaar, MD 1,5 ; Christopher P. Evans, MD 1,5 ; Marc A. Dall'era, MD 1,5 ; Rosemary Cress, MD 3,4,5 ; Stanley A. Yap, MD A contemporary population-based study of testicular sex cord stromal tumours: Presentation, treatment patterns, and predictors of outcome scsT: Detection and intervention chemotherapy. Controversy remains as to the recommended treatment due to a lack of evidence-based data.…”

Icariin induces apoptosis in mouse MLTC-10 Leydig tumor cells through activation of the mitochondrial pathway and down-regulation of the expression of piwil4

“…Currently, in most cases, the standard therapy for benign Leydig cell tumors is considered to be orchiectomy. Recently, by retrospectively analyzing the long-term follow-up of a series of patients with Leydig cell tumors electively treated with testis sparing surgery, Glannarin et al (5) demonstrated that testis sparing surgery with frozen section examination has an excellent long-term oncological outcome. Therefore, testis-sparing surgery may be chosen for treating benign Leydig cell tumors to maintain fertility, especially in boys and young men (5)(6)(7)(8)(9).…”

“…Recently, by retrospectively analyzing the long-term follow-up of a series of patients with Leydig cell tumors electively treated with testis sparing surgery, Glannarin et al (5) demonstrated that testis sparing surgery with frozen section examination has an excellent long-term oncological outcome. Therefore, testis-sparing surgery may be chosen for treating benign Leydig cell tumors to maintain fertility, especially in boys and young men (5)(6)(7)(8)(9). If the tumor is malignant, orchiectomy with retroperitoneal lymph node dissection is recommended, since chemotherapy and radiation therapy show limited efficacy in the treatment of malignant Leydig cell tumors.…”