title: Long-term followup after elective testis sparing surgery for Leydig cell tumors: a single center experience.
abstract: OBJECTIVE
  Although most Leydig cell tumors are benign, radical orchiectomy is currently considered the standard therapy. We retrospectively analyzed the long-term followup of a series of patients with Leydig cell tumors electively treated with testis sparing surgery.
  
  
  METHODS
  Between November 1990 and December 2005, 17 consecutive patients with Leydig cell tumors underwent testis sparing surgery on an elective basis. Preoperative evaluation included physical examination, serum markers for germ cell tumors, scrotal ultrasound, abdominal computerized tomography, chest x-ray and hormonal profile if clinically required. Testis sparing surgery was performed via an inguinal approach with spermatic cord clamping. Frozen section examination was performed in all cases, revealing Leydig cell tumors. Followup consisted of physical examination, scrotal ultrasound, abdominal computerized tomography and chest x-ray every 6 months for the first 2 years, then annually. Tumor recurrence and survival were evaluated.
  
  
  RESULTS
  Mean patient age was 41.6 years (range 28 to 55). Medical referral was prompted by symptoms/signs such as infertility, gynecomastia or self-palpation of scrotal mass in 11 patients (64.7%), while in the remaining 6 (35.3%) the lesions were incidentally diagnosed. Hormonal profile was performed in 9 patients, showing abnormalities in all. Mean tumor diameter was 13.4 mm (range 5 to 31). Definitive pathological examination confirmed benign Leydig cell tumor in all cases. After a mean followup of 91 months (range 12 to 192), neither local recurrence nor distant metastases have been detected and all patients are alive without evidence of disease.
  
  
  CONCLUSIONS
  In patients with Leydig cell tumors testis sparing surgery with frozen section examination provides an excellent long-term oncological outcome.
authors.affiliation: Department of Urology, University of Pisa, Pisa, Italy. gianluca.giannarini@hotmail.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Giannarini
authors.forename: Andrea
authors.initials: A
authors.lastname: Mogorovich
authors.forename: Filippo
authors.initials: F
authors.lastname: Menchini Fabris
authors.forename: Girolamo
authors.initials: G
authors.lastname: Morelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Maria
authors.forename: Francesca
authors.initials: F
authors.lastname: Manassero
authors.forename: Barbara
authors.initials: B
authors.lastname: Loggini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pingitore
authors.forename: Andrea
authors.initials: A
authors.lastname: Cavazzana
authors.forename: Cesare
authors.initials: C
authors.lastname: Selli
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007984:Leydig Cell Tumor / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000601:surgery*