Ultrastructural Features of Leydig Cell Hyperplasia Due to an hCG-Producing Testicular Tumor

Leydig cell clusters in the adult human testis are known to enlarge during chronic stimulation with excess LH as in Klinefelter's syndrome or following administration of exogenous human chorionic gonadotropin (hCG). However, the ultrastructural features of this hyperplasia, to our knowledge, have not been reported in association with testicular neoplasms producing hCG.We report the case of a 21-year-old man who sought medical attention because of gynecomastia. Laboratory investigation revealed a marked increase in serum hCG and elevated a-fetoprotein. A testicular mass was palpable on examination and the patient underwent orchiectomy.

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Hyperreactio luteinalis in association with multiple foetal malformations – a consequence of supra-physiological HCG?

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2013-0030 ◽

2014 ◽

Vol 3 (1) ◽

Author(s):

Majed Faden ◽

Amir H. Salehi ◽

Jeannine Simon ◽

Moy Fong Chen ◽

Atilla Omeroglu ◽

...

Keyword(s):

Chorionic Gonadotropin ◽

Leydig Cell ◽

Human Chorionic Gonadotropin ◽

Ultrasound Examination ◽

Second Trimester ◽

Cell Hyperplasia ◽

Foetal Development ◽

Rare Finding ◽

Testicular Hypertrophy ◽

Foetal Malformations

AbstractHyperreactio luteinalis (HL) is characterised by ovarian cystic enlargement that is associated with high levels of human chorionic gonadotropin (hCG). Here the possible effects of abnormally high hCG levels on foetal development are demonstrated.We report a 28-year-old patient who was referred for evaluation of bilateral maternal ovarian enlargement in the second trimester. Abnormally elevated hCG (887,514 IU/L) was found with ultrasound examination identifying various foetal malformations. The karyotype was normal. Spontaneous abortion occurred at 20 weeks. Autopsy showed testicular hypertrophy with marked Leydig cell hyperplasia. The HL resolved with normalisation of the hCG levels following delivery.HL is a rare finding in normal pregnancies; the potential effects of abnormally elevated hCG on the foetus are discussed.

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Leydig Cell Hyperplasia Due to a Testicular Embryonal Carcinoma Producing Human Chorionic Gonadotropin

Andrologia ◽

10.1111/j.1439-0272.1984.tb00254.x ◽

2009 ◽

Vol 16 (2) ◽

pp. 146-155 ◽

Cited By ~ 10

Author(s):

S.L. ASA ◽

T.A. BAYLEY ◽

K. KOVACS ◽

E. HORVATH

Keyword(s):

Chorionic Gonadotropin ◽

Leydig Cell ◽

Human Chorionic Gonadotropin ◽

Embryonal Carcinoma ◽

Cell Hyperplasia ◽

Leydig Cell Hyperplasia

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Does tumor-derived human chorionic gonadotropin act as a thyroid stimulator in vivo?

Clinical Chemistry ◽

10.1093/clinchem/39.2.229 ◽

1993 ◽

Vol 39 (2) ◽

pp. 229-233 ◽

Cited By ~ 6

Author(s):

S Madersbacher ◽

S Schwarz ◽

K Mann ◽

R Klieber ◽

G Wick ◽

...

Keyword(s):

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Testicular Tumor ◽

Thyroid Stimulating Hormone ◽

Serum Concentrations ◽

Thyroid Status ◽

Thyroxine Binding Globulin ◽

High Concentrations ◽

Physiological Values

Abstract To evaluate in vivo the proposed intrinsic thyroid-stimulating hormone (TSH) activity (TSA) of human chorionic gonadotropin (hCG), we monitored over 0.5-1 years the thyroid status of eight patients with hCG-producing non-seminomatous testicular cancer. The patients' sera were analyzed for concentrations of hCG, free thyroxine (fT4), hTSH, and thyroxine-binding globulin (TBG). All patients had excessively high concentrations of hCG (1 x 10(5)-5 x 10(8) ng/L, mean: 1 x 10(7) ng/L) before polychemotherapy, which decreased under successful therapy to physiological values (< 240 ng/L). Although the serum concentrations of hCG varied by more than six orders of magnitude, we saw no changes and no correlation (P > 0.05) between the concentrations of hCG and the concentrations of fT4 and hTSH. Not even when hCG concentrations were greatest (> 5 x 10(7) ng/L) were any signs of hyperthyroidism observed: fT4 (3.5-13 ng/L) and hTSH (9-700 ng/L) were in the physiological range in all patients and remained so during chemotherapy. The results of this longitudinal study were confirmed in analyzing the data for all eight patients (total: 82 samples) cross-sectionally. Again, we found no correlation (P > 0.05) between the concentrations of hCG and fT4 or hCG and hTSH. We conclude that even excessive amounts of testicular tumor-derived hCG do not display any TSH-like activity in vivo.

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