losartan-potassium and Dysgerminoma

While investigating the cause of mild polycythemia in a young man, a testicular seminoma was discovered with unusual and tumor-dependent features: an absolute polycythemia with high plasma erythropoietin (EPO) levels, an overproduction of estradiol and testosterone, and a dramatic Leydig cell hyperplasia surrounding the tumor tissue. The authors attempted to gain insight into the relationship between this testicular tumor and the hormonal overproduction, i.e., of EPO, estradiol, and testosterone. Their results favored the conclusion that the high EPO levels and the polycythemia were an indirect effect secondary to the steroid overproduction rather than a direct EPO-producing activity. Moreover, the steroid overproduction by the testis could be caused by a paracrine mechanism through human chorionic gonadotropin activity on the Leydig cells.

Topics: Adult; Chorionic Gonadotropin; Dysgerminoma; Erythropoietin; Estradiol; Humans; Hyperplasia; Leydig Cells; Male; Polycythemia; Steroids; Testicular Neoplasms; Testosterone

The authors report the case of a 41-year old patient with polycythaemia and a mixed testicular tumour (seminoma with choriocarcinomatous contingent). The demonstration of a raised erythropoietin level in the tumor tissue with a high gradient in relation to the serum argues in favour of secondary paraneoplastic polycythaemia. With a follow-up of 5 years, the patient is still in complete remission from his two diseases. This case may represent the first case of testicular tumour responsible for secondary polycythaemia.

Topics: Adult; Choriocarcinoma; Dysgerminoma; Erythropoietin; Humans; Male; Neoplasms, Multiple Primary; Polycythemia; Testicular Neoplasms