leuprolide and Testicular-Neoplasms

To analyse the urinary steroid metabolome in a boy who had true precocious puberty after a Leydig cell tumour.. Case report and detailed description of clinical and metabolic findings in a 7-year-old-boy with a Leydig cell tumour..   Before surgery, the urinary steroid metabolome showed an activation of an alternative route to gonadal androgens independent of dehydroepiandrosterone (DHEA). After surgery, the boy entered true precocious puberty. Under leuprolide acetate treatment, clinical and laboratory findings normalized.. Central precocious puberty after precocious pseudopuberty may be more common than expected and should be considered in children with persistent or recurrent symptoms after initial treatment of precocious pseudopuberty. Patients with a Leydig cell tumour seem to reactivate the so-called 'back door pathway' of androgen production, which is independent of the classical route via DHEA.

Topics: Androsterone; Antineoplastic Agents, Hormonal; Child; Dehydroepiandrosterone; Etiocholanolone; Humans; Leuprolide; Leydig Cell Tumor; Male; Metabolome; Pregnanolone; Puberty, Precocious; Testicular Neoplasms; Testosterone

The aim of this investigation was to test the hypothesis that testicular germ cell tumors (TGCTs) are hormone-dependent cancers. Human TGCT cells were implanted in the left testis of male severe combined immunodeficient mice receiving either no treatment or hormone manipulation treatment [blockade of gonadotropin-releasing hormone secretion and/or signaling using leuprolide or leuprolide plus exogenous testosterone]. Real-time RT-PCR analysis was used to determine the expression profiles of hormone pathway-associated genes. Tumor burden was significantly smaller in mice receiving both leuprolide and testosterone. Real-time RT-PCR analysis of follicle-stimulating hormone (FSH) receptor, luteinizing hormone (LH) receptor and P450 aromatase revealed changes in expression in normal testis tissue related to presence of xenograft tumors and manipulation of hormone levels but a complete absence of expression of these genes in tumor cells themselves. This was confirmed in human specimens of TGCT. Reduced TGCT growth in vivo was associated with significant downregulation of LH receptor and P450 aromatase expression in normal testes. In conclusion, manipulation of hormone levels influenced the growth of TGCT in vivo, while the presence of xenografted tumors influenced the expression of hormone-related genes in otherwise untreated animals. Human TGCTs, both in the animal model and in clinical specimens, appear not to express receptors for FSH or LH. Similarly, expression of the P450 aromatase gene is absent in TGCTs. Impaired estrogen synthesis and/or signaling may be at least partly responsible for inhibition of TGCT growth in the animal model.

Topics: Animals; Antineoplastic Agents, Hormonal; Aromatase; Estrogens; Gene Expression Profiling; Humans; Leuprolide; Male; Mice; Mice, SCID; Neoplasms, Germ Cell and Embryonal; Receptors, FSH; Receptors, LH; Reverse Transcriptase Polymerase Chain Reaction; Testicular Neoplasms; Testosterone; Transplantation, Heterologous

Prostate carcinoma presenting initially as multiple pulmonary nodules in an asymptomatic patient without previous prostate carcinoma is unusual. Whether the incidence of prostate carcinoma is significantly increased in patients treated previously for germ cell tumors is unclear. We report such a patient, who responded to combination androgen blockade therapy.

Topics: Adenocarcinoma; Adult; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Etoposide; Flutamide; Humans; Leuprolide; Lung Neoplasms; Male; Neoplasms, Germ Cell and Embryonal; Neoplasms, Multiple Primary; Neoplasms, Second Primary; Orchiectomy; Postoperative Complications; Prostatic Neoplasms; Radiography; Testicular Neoplasms

Topics: Animals; Cyclophosphamide; Disease Models, Animal; Gonadotropin-Releasing Hormone; Gonadotropins, Pituitary; Humans; Leuprolide; Male; Mice; Mice, Inbred BALB C; Secretory Rate; Spermatogenesis; Spermatogonia; Testicular Neoplasms