title: Malignant interstitial cell carcinoma of the testis: report of two cases with steroid synthetic profiles, response to therapy, and review of the literature.
abstract: Two cases of malignant interstitial cell carcinoma of the testis are reported. The first patient had no evidence of a virilizing syndrome. Basal plasma testosterone (T) was decreased, whereas plasma luteinizing hormone, estrone (E1), and androstenedione were elevated. These findings were diagnostic of a defect in T secretion as a result of a partial 17-hydroxysteroid dehydrogenase deficiency as seen in male pseudohermaphroditism. In the second patient, showing gynecomastia and atrophic testis, endocrine studies revealed high plasma T and estradiol (E2); all measured delta 4 and delta 5 precursors of T were elevated resembling the pattern seen in virilizing adrenal carcinomas. Both patients were treated with radiotherapy without demonstrable effect. Chemotherapy--consisting of a combination of cis-platinum, vinblastine, and bleomycin; then cyclophosphamide, doxorubicin, and vincristine; and finally o,p'-DDD--was unsuccessful in reducing tumor bulk. Since malignant Leydig cell carcinomas are rare, this paper reviews the literature and makes recommendations concerning treatment.
mesh_terms: D015068:17-Ketosteroids / Q000378:metabolism; D000305:Adrenal Cortex Hormones / Q000378:metabolism; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007984:Leydig Cell Tumor / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010908:Pituitary Hormones, Anterior / Q000097:blood; D013736:Testicular Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy
chemical_list: D015068:17-Ketosteroids; D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D012739:Gonadal Steroid Hormones; D010908:Pituitary Hormones, Anterior