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4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Leydig cell tumour is the commonest testicular tumour that is not a germ cell tumour; it grows from the hormone-making cells between the tubules. It often makes testosterone or oestrogen, causing early puberty in boys or breast growth in men, and nine in ten are benign and cured by surgery. No chemotherapy works in the malignant tenth, managed case by case at a specialist centre.
Leydig cell tumours are sex cord-stromal tumours of the testis, listed in the WHO classification apart from the germ cell tumours that make up most testicular cancer (Moch 2016). They are the most common non-germ cell neoplasms of the testis and are often hormonally active, producing precocious virilisation in boys or feminisation in adults (JCEM 2006). Malignancy, defined by metastasis rather than by histology alone, occurs in up to 10 percent, with large size, necrosis, vascular invasion, atypia and high mitotic count as warning features; the main differential in boys with congenital adrenal hyperplasia is the testicular adrenal rest tumour, which responds to steroid suppression (Avicenna Journal of Medicine 2013). Germline fumarate hydratase mutations, the cause of the HLRCC syndrome, were found in two of 30 adult Leydig cell tumours, with loss of the wild-type allele and activation of the hypoxia pathway (JCEM 2006).
How it differs from its parent: the testicular page describes germ cell tumours, cured by cisplatin; Leydig cell tumours do not respond to that chemotherapy, do not raise the germ cell markers, and are staged and managed as a sex cord-stromal tumour, with testis-sparing surgery possible for small benign tumours.
| Setting | Approach | Guideline |
|---|---|---|
| All cases | Orchidectomy (testis-sparing for small benign tumours); retroperitoneal node dissection for malignant features; no chemotherapy has shown benefit in metastatic disease, which is planned case by case at a specialist centre with trials considered. | not mapped |