What are the other Names for this Condition? (Also known as/Synonyms)

• Malignant Leydig Cell Tumor of the Testicles
• Malignant Testicular Leydig Cell Tumor

What is Malignant Leydig Cell Tumor of the Testis? (Definition/Background Information)

• Leydig cell tumors (LCTs) of the testis are testicular tumors affecting the stromal cells of the testis. Stromal cells are the structural and hormone-producing cells of the testis
• In a vast majority of cases, the Leydig cell testicular tumors are benign in nature; almost all cases in children and about 90% of the cases in adults are benign. Malignant Leydig Cell Tumors of the Testis are therefore highly infrequent and only seen in adults (middle-aged and older)
• The testes are the male reproductive organs, equivalent to the ovaries in women. They are housed in the scrotum; the sac-like structure in the groin. The testis have 2 main functions:
  • Male hormone production
  • Sperm production
• There are two types of cells in the testis:
  • Germ cells, which give rise to sperms
  • Stromal cells, which lend support to the testis and have hormone-producing ability
• There are two main types of stromal cells:
  • Leydig cells: They make the sex hormones, mainly testosterone and also estrogen
  • Sertoli cells: They support the germ cells as they make sperms
• Testicular cancer is cancer of the testicle, or testis. It is the most common form of cancer in young men aged 15-35 years. It is generally aggressive, but treatable when identified early
• Stromal tumors make up 5-10% of the testicular cancers. Moreover, they comprise up to 20% of the testicular cancers in children
• Stromal cell tumor cells may be mixed with germ cell tumor cells. Stromal cell cancers are not as dangerous as germ cell cancers, because they are not as likely to spread or metastasize
• The cause of Malignant Leydig Cell Tumor of the Testis is unknown, although several risk factors, such as family history, weak immunity, or atrophy of testicles, are identified
• Malignant Leydig Cell Tumor of the Testes can rarely spreads to other parts of the body. In such cases, it is difficult to treat the condition, because the malignancy is resistant to chemotherapy and radiation therapy

Who gets Malignant Leydig Cell Tumor of the Testis? (Age and Sex Distribution)

Males at risk for Leydig Cell Tumor of the Testis include:

• Adults of all ages, especially those between the ages of 30-60 years
• Caucasians

What are the Risk Factors for Malignant Leydig Cell Tumor of the Testis? (Predisposing Factors)

In general, the following are factors that increase one’s susceptibility to Malignant Leydig Cell Tumor of the Testis:

• Family history of testicular cancer
• Caucasian descent
• Decreased immunity, especially due to HIV/AIDS
• Kidney transplant
• Presence of carcinoma in situ (CIS), or intra-tubular germ cell neoplasia
• Hypospadias (male birth defect affecting the urethra)
• Inguinal hernia
• Testicular atrophy
• Gonadal dysgenesis
• Infertility
• Smoking
• Exposure to radiation and industrial chemicals
• Chemotherapy
• Viruses (in some rare cases)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Malignant Leydig Cell Tumor of the Testis? (Etiology)

The cause of Malignant Leydig Cell Tumor of the Testis is unknown.

• It is believed that abnormal differentiation of germ cells gives rise to cancerous cells that lead to the formation of this condition
• However, how this occurs and the factors that cause it remain under investigation

What are the Signs and Symptoms of Malignant Leydig Cell Tumor of the Testis?

The signs and symptoms of Malignant Leydig Cell Tumor of the Testis may include:

• Loss of libido
• Overdevelopment of breasts in males (gynecomastia)
• Breast pain, especially if accompanied by enlargement
• Trouble breathing
• Headache
• Low blood pressure
• Anemia
• Testicular pain, lump in the testes, feeling of heaviness in the scrotum
• Abdominal pain and swelling
• Back pain
• Swelling of the legs
• Constipation
• Changes in appetite
• Fatigue
• Frequent urination
• Paralysis

How is Malignant Leydig Cell Tumor of the Testis Diagnosed?

Following are techniques that aid in identifying Malignant Leydig Cell Tumor of the Testis:

• Physical examination to detect lumps in the testicles, which do not allow light to pass through
• Tissue biopsy followed by microscopic analysis and staining
• Blood tests that include:
  • Complete blood cell count (CBC) blood test
  • Liver function blood test (LFT)
  • Serum tumor marker blood test to detect increases in human chorionic gonadotropin (hCG)
  • Alpha-fetoprotein (AFP) blood test
  • Lactate dehydrogenase (LDH) blood test
  • Testosterone levels blood test
• Genetic testing to determine mutations associated with Malignant Testicular Leydig Cell Tumor
• Radiological imaging including:
  • X-Ray of the chest, abdomen, and pelvis
  • Ultrasound of the pelvis       
  • Computerized tomography (CT) scan of the brain
  • Vascular radiological studies
  • Whole body bone scan
  • Positron emission tomography (PET) scan

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Malignant Leydig Cell Tumor of the Testis?

Following are complications that may arise from Malignant Leydig Cell Tumor of the Testis:

• Infertility
• Retrograde ejaculation
• Excessive blood loss
• Metastasis and the loss of function of the organ (usually lung and liver) to which the cancer has spread
• Recurrence of Malignant Testicular Leydig Cell Tumor, which may take place even after a decade following surgery to remove the tumor

How is Malignant Leydig Cell Tumor of the Testis Treated?

Treatments for Malignant Leydig Cell Tumor of the Testis may include the following procedures:

• Removal of the original tumor and the metastatic tumors
• Removal of the testis
• Debulking surgery to reduce tumor size, followed by chemotherapy
• Clotting the vessels in the tumor (embolization)
• Chemotherapy
• Radiotherapy
• Undertaking treatment of underlying conditions, if any

How can Malignant Leydig Cell Tumor of the Testis be Prevented?

In some cases, Malignant Leydig Cell Tumor of the Testis may be avoided through the following measures:

• Monthly testicular self-examination
• Genetic testing in individuals with a family history
• Limiting exposure to radiation and industrial chemicals
• Limiting chemotherapy
• Not smoking

What is the Prognosis of Malignant Leydig Cell Tumor of the Testis? (Outcomes/Resolutions)

• The prognosis for Malignant Leydig Cell Tumor of the Testis is comparatively better for cases in which the cancer has not spread (metastasized)
• The following factors determine the prognosis of the condition:
  • Size of the tumor
  • Stage of the tumor     
  • Age of the individual
  • Overall health of the individual
  • Tumor location in the testes
  • Number of tumor masses present within the testes
• Also, the tumor is known to recur even after 8-15 years following its surgical removal. Hence, periodic, long-term surveillance is important and necessary

Additional and Relevant Useful Information for Malignant Leydig Cell Tumor of the Testis:

• Testicular cancers are aggressive in nature; they are also very quick to develop. Nonetheless, they are readily treatable
• Testicular cancer is the most common form of cancer in US men aged 15 to 35 years. However, it is still relatively uncommon, with 5,500 cases in the US each year and 0.2-10.3 cases worldwide per 100,000 persons
• In a study of 20 individuals aged 5-61 years with Leydig Cell Tumor of the Testis, who had undergone moderate surgery; all were cured and alive 15 years later