Academic Department of Urology, IRCCS Policlinico San Donato, University of Milan, Largo Malan 1, Milan, Italy.
Clin Genitourin Cancer. 2013 Sep;11(3):321-4. doi: 10.1016/j.clgc.2012.12.008. Epub 2013 Jan 11.
Our objective was to perform a long-term evaluation of conservative surgical treatment of Leydig cell tumors.
A multicenter retrospective clinical study was performed at 6 European centers. Case files of all patients diagnosed with Leydig cell tumor and treated with conservative surgery were examined. Patients underwent physical examination, hormone and tumor marker assays, scrotal and abdominal ultrasonography, chest radiography, and endocrinologic examination.
From 1987 to 2006, 22 patients with Leydig cell tumor underwent conservative surgery. Mean patient age was 35 years (range, 5-61 years). Mean follow-up was 180 months (range, 77-290 months). No local recurrence or metastasis was observed. Patients presented with a palpable testicular nodule (3 patients [13.7%]), a nodule diagnosed by ultrasonography (15 patients [68.2%]), gynecomastia (2 patients [9.1%]), precocious pseudopuberty (1 patient [4.5%]), or scrotal pain (1 patient [4.5%]). Diagnosis after frozen section examination was Leydig cell tumor in 20 of 22 patients (91%). Mean histologic size of the nodule was 1.11 cm. Follow-up was conducted for all patients every 3 to 6 months, with physical examination, tumor marker assays, scrotal and abdominal ultrasonography, chest radiography, and computed tomography (CT). No local recurrences or metastases were observed. One hundred percent of patients are still alive with a 100% disease-free survival.
When diagnosed and treated early, long-term favorable outcomes are seen at follow-up in Leydig cell tumors, even with its potential metastatic behavior. In these patients, testicle-sparing surgery proved to be a feasible and safe choice and could be regarded as the first line of therapy.
我们的目的是对莱迪希细胞瘤的保守手术治疗进行长期评估。
在欧洲的 6 个中心进行了一项多中心回顾性临床研究。检查了所有经诊断为莱迪希细胞瘤并接受保守手术治疗的患者的病历。患者接受了体格检查、激素和肿瘤标志物检测、阴囊和腹部超声、胸部 X 线检查和内分泌检查。
1987 年至 2006 年，22 例莱迪希细胞瘤患者接受了保守手术。患者平均年龄为 35 岁（范围 5-61 岁）。平均随访时间为 180 个月（范围 77-290 个月）。未观察到局部复发或转移。患者表现为可触及的睾丸结节（3 例[13.7%]）、超声诊断的结节（15 例[68.2%]）、男性乳房发育症（2 例[9.1%]）、性早熟性假性性早熟（1 例[4.5%]）或阴囊疼痛（1 例[4.5%]）。22 例患者中有 20 例（91%）经冷冻切片检查诊断为莱迪希细胞瘤。结节的平均组织学大小为 1.11cm。所有患者均接受随访，每 3-6 个月进行一次体格检查、肿瘤标志物检测、阴囊和腹部超声、胸部 X 线检查和计算机断层扫描（CT）。未观察到局部复发或转移。所有患者均存活，无疾病生存率为 100%。
莱迪希细胞瘤早期诊断和治疗，即使有潜在的转移行为，在随访中也能获得长期良好的结果。在这些患者中，保留睾丸手术被证明是一种可行且安全的选择，可以作为一线治疗方法。
