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Leydig-cell tumour of the testis: retrospective analysis of clinical and therapeutic features in 204 cases

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Abstract

Purpose

Leydig-cell tumours (LCT) of the testis are poorly understood clinically. The aim of this report is to analyse the clinical characteristics of LCT in a large patient sample and to compare these findings with corresponding data of germ-cell tumours (GCT).

Methods

In a sample of 208 patients treated during 1995–2017 in 33 institutions, the following characteristics were registered: age, presenting symptoms, primary tumour size, testis-sparing surgery (TSS) or orchiectomy, malignancy, laterality, medical history, and outcome. Data analysis included descriptive statistical methods and logistic regression analysis.

Results

The ratio LCT:GCT is 1:23 (4.4%). The findings are as follows: median age 41 years, undescended testis 8%, bilateral LCTs 3%, malignant LCT 2.5%, contralateral GCT 2.5%, incidental detection 28%, scrotal symptoms 43%, infertility 18%, elevated estradiol levels 29%. TSS was performed in 56% with no local relapse. Of the patients with malignant LCT, one was cured through surgery.

Conclusion

LCT is rare, with a relative frequency (relative to GCT) of 1:23. Malignancy is found in 2.5%. LCT and GCT share a number of clinical features, e.g. bilaterality, history of undescended testis, and presenting age. TSS is safe in benign LCT. Surgery is the treatment of choice in malignant LCT.

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Author information

Author notes

  1. Christian Guido Ruf and Nojan Sanatgar are joint first authors.

Authors and Affiliations

  1. Bundeswehrkrankenhaus Hamburg, Hamburg, Germany

    Christian Guido Ruf & Nojan Sanatgar

  2. Abteilung für Urologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany

    Christian Guido Ruf

  3. Martini Klinik Hamburg, Hamburg, Germany

    Hendrik Isbarn

  4. Asklepios Klinik Harburg, Hamburg, Germany

    Birgit Ruf

  5. Ortenau-Klinikum Offenburg, Offenburg, Germany

    Jörg Simon

  6. Universität Zürich, Zürich, Switzerland

    Christian Daniel Fankhauser

  7. Asklepios Klinik Altona, Hamburg, Germany

    Klaus-Peter Dieckmann

Authors
  1. Christian Guido Ruf
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  2. Nojan Sanatgar
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  3. Hendrik Isbarn
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  4. Birgit Ruf
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  5. Jörg Simon
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  6. Christian Daniel Fankhauser
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  7. Klaus-Peter Dieckmann
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Contributions

CGR: project development, data collection, data analysis, manuscript editing. NS: data collection, data analysis, project development. HI: data management, data analysis, manuscript writing. BR: data collection, data analysis, JS: manuscript writing and editing, data management. CDF: project development, data collection. KPD: project development, data collection, data analysis, manuscript writing and editing.

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Correspondence to Christian Guido Ruf.

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Ruf, C.G., Sanatgar, N., Isbarn, H. et al. Leydig-cell tumour of the testis: retrospective analysis of clinical and therapeutic features in 204 cases. World J Urol 38, 2857–2862 (2020). https://doi.org/10.1007/s00345-020-03079-1

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  • DOI: https://doi.org/10.1007/s00345-020-03079-1

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