Persistent Hyperprolactinemia after Orchidectomy due to a Feminizing Leydig Cell Tumorperiod; Effect of Treatment with Quinagolide lpar;CV 205ndash;502rpar;

摘要

Hyperprolactinemia after orchidectomy in patients with feminizing Leydig cell tumors has not been described previously. We report the case of a 24-year-old man with bilateral gynecomastia of 6 months' duration who was found to have a Leydig cell tumor in his left testis. Hormone studies performed before surgery revealed mild hyperprolactinemia, increased follicle-stimulating hormone (FSH), and normal testosterone and estradiol levels. Spermatogenesis was abnormal. Testicular endocrine function and spermatogenesis did not return to normal after surgery. Over 2 years of ldquo;follow-up,rdquo; FSH levels gradually increased while luteinizing hormone levels remained at the upper limit of the normal range. Estradiol levels decreased by 75percnt;, and prolactin (PRL) remained high at preorchidectomy values. Treatment with quinagolide (CV 205ndash;502) normalized PRL levels but failed to correct sperm abnormalities.We conclude that lack of endocrine normalization after hemicastration might suggest preexisting testicular damage aggravated by long-term exposure to high levels of estrogen.