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Minerva Urologica e Nefrologica 1998 December;50(4):241-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: English

Hormonal profile of patients with Leydig cell tumors: a urologic cause of gynecomastia

Sciarra A., Casale P., Di Nicola S., Di Chiro C., Di Silverio F.

University of Rome “La Sapienza” - Rome, Department of Urology “U. Bracci”

It is pos­sible to hypoth­e­size an alter­na­tive ­role for estro­gens as a pre­dis­posing ­factor for tes­tic­ular abnor­mal­ities: ­estrogen expo­sure ­during devel­op­ment in per­i­natal ­life may ­initiate cel­lular ­changes ­which ­would ­require ­estrogen and/or ­androgen ­later in ­life for pro­mo­tion to hyper­plasia or neo­plasia. We ­reviewed the lit­er­a­ture on ­Leydig ­cell ­tumors and the hor­monal mod­ifi­ca­tions ­they ­induce. In ­adult ­patients ­with ­Leydig ­cell ­tumors, ­although the ­serum ­estrogen (E2) and tes­tos­te­rone (T) ­varied, the T/E2 ­ratio was con­stantly low, and the chor­ionic gon­a­dot­ropin admin­is­tra­tion pro­duced an ­higher ­estrogen ­response ­than in ­normal men. Hor­monal ­follow-up ­after orchi­dec­tomy for ­Leydig ­cell ­tumors has not ­been fre­quently ­described, and ­both nor­mal­iza­tion and ­lack of nor­mal­iza­tion of T, E2, gon­a­dot­ro­pins and hCG ­have ­been ­reported. In the ­last ­part of the ­review we ana­lyzed the prin­cipal uro­logic ­causes of gynec­o­mastia in men. Tes­tic­ular ­failure, ­either pri­mary or sec­on­dary is a fre­quently ­found eti­ology for gynec­o­mastia. ­Leydig ­cell ­tumors may ele­vate ­estrogen ­levels, and approx­i­mately 20% of ­patients ­with ­these ­tumors ­have gynec­o­mastia.