Mitotane Treatment for Malignant Leydig Cell Tumor: A Case Report.

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.