Mitotane Treatment for Malignant Leydig Cell Tumor: A Case Report

Q4 Medicine

IJU Case Reports Pub Date : 2025-07-27 DOI:10.1002/iju5.70078

Daiki Katsura, Mototsugu Muramaki, Takashi Okamoto, Masaya Yamamoto, Mizuki Yutaka, Shohei Morita, Takuya Fujimoto, Yuji Yamada

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Abstract

Introduction

Leydig cell tumors (LCTs), constituting 1%–3% of testicular tumors, are mostly benign, but malignant cases present treatment challenges. We report a malignant LCT case with a notable response to mitotane.

Case Presentation

A 43-year-old male presented with a right testicular induration and was diagnosed with a Leydig cell tumor following orchiectomy. BEP chemotherapy was initiated for the liver metastases, but after four cycles, new lymph node and bone lesions appeared. Mitotane was started, which markedly reduced liver and nodal metastases. However, due to fatigue, anorexia, and nipple discomfort, mitotane was discontinued. The disease progressed, and the patient died 4 years post-diagnosis and 14 months after starting mitotane.

Conclusion

Mitotane shows promise in treating malignant LCTs, but careful management of adverse effects is necessary.

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米托坦治疗恶性间质细胞瘤1例

睾丸间质细胞瘤（lct）占睾丸肿瘤的1%-3%，大多为良性，但恶性病例的治疗具有挑战性。我们报告一个恶性LCT病例与显著响应米托坦。病例介绍一名43岁男性，在睾丸切除术后出现右侧睾丸硬化，并被诊断为睾丸间质细胞瘤。肝转移开始BEP化疗，但四个周期后出现新的淋巴结和骨病变。开始使用米托坦，显著减少肝脏和淋巴结转移。然而，由于疲劳、厌食症和乳头不适，停用米托坦。病情进展，患者在诊断后4年和开始使用米托坦后14个月死亡。结论米托坦治疗恶性LCTs有较好的疗效，但不良反应需谨慎处理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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