A 28-year-old man with evidence of feminization was demonstrated after 4 years of investigation to have a estrogen-secreting interstitial cell tumor. Such feminizing neoplasms are uncommon, only 37 having been described. They are usually benign and are characterized by gynecomastia, a testicular mass and, with lesser frequency, by decreased libido and potency and poor semen quality. The urinary excretion and plasma levels of estrogen are increased and, by selective testicular catheterization, the site of increased estrogen production can be localized. Secondary histologic changes occur in the nontumorous portions of the testis as well as in the contralateral testis; they are most marked in the area immediately adjacent to the tumor. Postoperatively, the gynecomastia regresses, the excessive levels of estrogen return to normal, libido improves, and the sperm count increases to normal.

Feminizing interstitial cell tumor of the testis: personal observations and a review of the literature.

Testicular tumors in prepubertal children.

TUMORS derived from steroid hormone-producing cells of the adrenal, ovary, and testes are rare. The tumors are, however, important both as causes of disease entities and as useful model systems for the study of steroidogenesis. Certain features of steroidogenic tumors complicate the diagnosis, prognosis, and treatment. Steroidogenic tumors frequently are neither suspected nor detected until they are very large or metastatic. This sometimes occurs because the tumor does not produce a recognizable endocrine syndrome. Even when the tumor produces a distinct syndrome, the anatomical location of the tumor may not be inferred from steroid hormone secretory patterns or trophic hormone responsiveness. Furthermore, tumors of the adrenal (1–9) or testes (10) may cause Cushing's Syndrome, and virilization or feminization syndromes may be caused by adrenal (11, 12), testicular (13–19), or ovarian tumors (20–36). Some of these tumors respond to trophic hormone stimulation, either to the appropriate trophic hormone for...

Steroid hormone-producing tumors in man.

Gonadal stromal tumors, gonadoblastomas, epidermoid cysts, and secondary tumors of the testis in children.

A patient with a testicular interstitial cell tumor and gynecomastia is reported. The testicular tumor was capable of aromatizing 8.3% testosterone. Spermatic venous samples taken from the tumor-bearing side had marked elevations of 17 beta-estradiol (E2), progesterone, and 17-hydroxyprogesterone (170 HP). The progesterone to 17OHP and 17OHP to androstene-dione ratios suggested an enzymatic block of 17 alpha-hydroxylase and 17-20 lyase possibly secondary to locally produced E2. The E2 produced by the tumor appeared to suppress gonadotropin secretion. The plasma testosterone and gonadotropin levels rose within 7 days after the removal of tumor, and the gynecomastia began to decrease.

Fred Smith

Papers

Local Androgenic Effect of Interstitial Cell Tumor of the Testis