米托坦治疗恶性莱迪希细胞瘤：一例报告
Mitotane Treatment for Malignant Leydig Cell Tumor: A Case Report.
作者信息
Katsura Daiki, Muramaki Mototsugu, Okamoto Takashi, Yamamoto Masaya, Yutaka Mizuki, Morita Shohei, Fujimoto Takuya, Yamada Yuji
机构信息
Department of Urology Kobe University Graduate School of Medicine Kobe Japan.
Department of Urology Hyogo Prefectural Amagasaki General Medical Center Amagasak Japan.
出版信息
IJU Case Rep. 2025 Jul 27;8(5):498-502. doi: 10.1002/iju5.70078. eCollection 2025 Sep.
INTRODUCTION
Leydig cell tumors (LCTs), constituting 1%-3% of testicular tumors, are mostly benign, but malignant cases present treatment challenges. We report a malignant LCT case with a notable response to mitotane.
CASE PRESENTATION
A 43-year-old male presented with a right testicular induration and was diagnosed with a Leydig cell tumor following orchiectomy. BEP chemotherapy was initiated for the liver metastases, but after four cycles, new lymph node and bone lesions appeared. Mitotane was started, which markedly reduced liver and nodal metastases. However, due to fatigue, anorexia, and nipple discomfort, mitotane was discontinued. The disease progressed, and the patient died 4 years post-diagnosis and 14 months after starting mitotane.
CONCLUSION
Mitotane shows promise in treating malignant LCTs, but careful management of adverse effects is necessary.
引言
间质细胞瘤（LCTs）占睾丸肿瘤的1%-3%，大多为良性，但恶性病例的治疗具有挑战性。我们报告一例对米托坦有显著反应的恶性间质细胞瘤病例。
病例介绍
一名43岁男性因右侧睾丸硬结就诊，睾丸切除术后被诊断为间质细胞瘤。因出现肝转移开始接受BEP化疗，但四个周期后，出现了新的淋巴结和骨转移灶。开始使用米托坦治疗，肝转移灶和淋巴结转移灶明显减少。然而，由于疲劳、厌食和乳头不适，停用了米托坦。疾病进展，患者在确诊后4年及开始使用米托坦14个月后死亡。
结论
米托坦在治疗恶性间质细胞瘤方面显示出前景，但必须谨慎处理不良反应。
Zotero 插件