Altered Leydig cell function in patients with testicular cancer: evidence for bilateral testicular defect.

In search of an abnormality in Leydig cell function in patients with testicular cancer, serum levels of testosterone, oestradiol, LH and FSH were compared in 3 groups of men. Group I comprised 26 patients studied after recent orchidectomy for a testicular carcinoma, group II 8 patients operated for benign testicular lesions and group III 8 normal controls. In group II normal testosterone values were found as a result of increased LH release. In group I patients, however, testosterone levels often were low, despite elevated LH levels and increased LH capacity. Evidently, in these patients a partial Leydig cell insufficiency may be present, which does not recover within one year of orchidectomy. After removal of one testis for benign disease, normal testosterone levels are maintained by increased LH levels. After orchidectomy for testicular carcinoma a partial Leydig cell insufficiency may be revealed, which seems to have a permanent character. A pre-existent Leydig cell insufficiency of the remaining testis in patients with testicular cancer indicates a bilateral testicular defect.