PARTE TERZA
[1] Richie JP. Neoplasms of the testis. In: Walsh PC et al, editors. Campbells urology. 7th ed. Philadelphia: WB Saunders, 1997, pp 2411-2452.
[2] Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol 2003;170:5-11.
[3] McGlynn KA, Devesa SS, Sigurdson AJ, Brown LM, Tsao L, Tarone. RE. Trends in the incidence of testicular germ cell tumors in the United States. Cancer 2003;97:63-70.
[4] Bosl GJ, Motzer RJ. Testicular germ-cell cancer. N Engl J Med 1997;337:242-253.
[5] Zucchi A, Mearini E, Mearini L. Tumori del testicolo. In: Albertazzi A, Porena M. Malattie del rene e delle vie urinarie, Edizione Piccin, 2003, pagg. 745-60.
[6] WHO histological classification of testis tumors. In: JN Eble, G.
Sauter, JL Epstein, IA Sesterhenn, editori. Pathology & Genetics. Tumours
of the Urinary System and male genital organs. IARC, lyion, 2004, pag. 218-258.
[7] Albers P., Albrecht W., Algaba F., Bokemeyer C., Cohn-Cedermark
G., Horwich A., Klepp O., Laguna MP., Pizzocaro G. Guidelines on
[8] Cavalli F, Monfardini S, Pizzocaro G (1980) Report on the
international workshop on staging and treatment of testicular cancer. Eur J Cancer 16: 1367-1372
[9] International Germ Cell Cancer Collaborative Group. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997;15:594-603. [10] Bono AV, Bonadonna G. Neoplasie del testicolo. In: Bonadonna G, Robustelli della Cuna GB, Valagussa P. Medicina oncologica. VII edizione, 2003, pag. 1069
[11] Bono AV, Bonadonna G. Neoplasie del testicolo. In: Bonadonna G, Robustelli della Cuna GB, Valagussa P. Medicina oncologica. VII edizione, 2003, pag 1070-1071.
[12] Doerr A., Skinner E. C., Skinner D. G., preservation of eiaculatio n trought a modified retroperitoneal lynphonode dissection in low stage testis cancer. J Urol 149,1472-1474,1993.
[13] Donohue J.P., Thorhill J. A., Foster R. S., Primary retroperitoneal lynphonode dissection in a clinical stage A non-seminomatous germ cell testis cancer. Rewiew of the Indiana University experience 1965-1989. J Urol 71,326-335,1993.
[14] Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB, Donohue JP, Paulson DF, Brunner KW, Jacobs EM, Spaulding JT. Immediate adjuvant chemotherapy versus observation with treatment at
relapse in pathological stage II testicular cancer. N Engl J Med 1987;317:1433-1438.
[15] Eihorn L. Stender M. Phase II trials of gemcitabine in refractory germ cell tumor. J Clin Oncol 17.509-511,1999.
[16] Motzer R. J., Mazumdar M., Sequential dose-intensive paclitaxel, ifosfamide, carboplatin and etoposide salvage therapy for germ cell tumor patients. J Clin Oncol 18, 1173-1180,2000.
[17] Oliver R. T. D., Chemotherapy as primary treatment modality for testicular seminoma. In Alderson A.R. , Oliver R.T.D.,Urological Oncology Wiley e sons, Chichester,1991, pp. 289-302.
[18] Ondrus D, Matoska J, Belan V. Prognostic factors in clinical stage I nonseminomatous germ cell testicular tumors: rationale for different risk-adapted treatment. Eur Urol 1998;33:562-566.
[19] Schmoll HJ, Souchon R, Krege S, Albers P, Beyer J, Kollmannsberger
C, et al. European consensus on diagnosis and treatment of germ cell
cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004;15:1377-1399.
[20] Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB,
Donohue JP, Paulson DF, Brunner KW, Jacobs EM, Spaulding JT.
Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer. N Engl J Med
[21] Weissbach L, Bussar-Maatz R, Fletchner H, Pichlmeier U, Hartmann
M, Keller L. RPLND or primary chemotherapy in clinical stage IIA/B
nonseminomatous germ cell tumors. Results of a prospective multicenter trial including quality of life assessment. Eur Urol 2000;37:582-594.
[22] Horwich A, Norman A, Fisher C, Hendry WF, Nicholls J, Dearnaley
DP. Primary chemotherapy for stage II nonseminomatous germ cell tumors of the testis. J Urol 1994;151:72-8.
[23] Anatomia Umana G. C. Balboni: Apparato genitale maschile
[24] Cheville JC, Sebo TJ, Lager DJ, Bostwick DG, Farrow GM. Leydig cell tumour of the testis: a clinicopathologic, DNA content, and MIB-1 comparison of nonmetastasizing and metastasizing tumours. Am J Surg Pathol 1998;22:1361-1367.
[25] Nistal M, Paniagua R, Regaera J, Santamaria L, Amat P. A quantitative morphological study of human Leydig cells frm birth to adulthood. Cell Tissue Res. 1986; 246 (2): 229-36.
[26] Nistal M, Gonzalez-Peramato P, Panigu R. Congenital Leydig cell hyperplasia. Histopathology 1988; 12 (3): 307-17.
[27] Kothari LK, Gupta AS. Effect of ageing on the volume, structure and total Leydig cell content of the human testis. Int J Fertil. 1974; 19 (3): 1406.
[28] Kaler LW, Neaves WB. Attrition of the human Leydig cell population with advacin age. Anat Rec. 1978; 192 (4): 513-8.
[29] Mori, Hiromoto N, Nakahara M, Shiraishi T. Sterological analysis of
Leydig cell ultrastructure in aged humans. J Clin Endocrinol Metab. 1982; 55 (4): 634-41
[30] Richie JP. Neoplasms of the testis. In: Campbell’s Urology. 7th ed Walsh PC et al. WB Saunders Co: Philadelphia, 1997, 2411-2452.
[31] Oliva E, Young RH. Paratesticular tumor-like lesions. Semin Diagn Pathol. 2000; 17 (4): 340-58.
[32] Nistal M, Paniagua R. Histogenesis of human extraparenchymal Leydig cells. Acta Anat (Basel). 1979; 105 (2): 188-97.
[33] Grignon DJ, Ro JY, Ordonez NG, Ayala AG. Extratesticular interstitial cells. Am J Surg Pathol. 1988, Sep; 12 (9): 735-6.
[34] Lanzafame S, Leonardi R, Torrisi A. Extratesticular Leydig cell tumor of the spermatic cord. J Urol. 2004; 171 (3): 1238-9.
[35] Regadera J, Codesal J, Paniagua R, Gonzalez-Peramato P, Nistal M. Immunohistochemical and quantitative study of interstitial and intratubular Leydig cells in normal men, cryptorchidism and Klinefelter’s syndrome. J Pathol. 1991; 164 (4): 634-41.
[36] Allen FJ, Van Vallenhoven F. Leydig cell tumor of intra-abdominal testis. Urology 1993; 42 (6): 729-31.
[37] Dounis A, papacharalampous A. Clinically occult Leydig cell tumor in a criptorchid man. Report of a case presenting with unilateral gynecomastia and impotence. Eur Urol 1997; 32: 368-70.
[38] Nistal M, Santamaria L, Paniagua R, Regadera J, Codesal J. Multinucleate Leydig cells in normal human testes. Andrologia. 1986; 18 (3): 268-72.
[39] Kim I, Young RH, Scully RE. Leydig cell tumors of the testis. A clinicopathological analysis of 40 cases and review of the literature. Am J Surg Pathol. 1985; 9 (3): 177-92
[40] Liu G, Duranteau L, Carel JC, Monroe J, Doyle DA, Shenker A. Leydig cells tumors caused by activating mutation of the gene encoding the luteinizing hormone receptor. N Engl J Med. 1999; 341 (23): 1731-6. [41] Clegg ED, Cook JC, Chapin RE, Foster PM, Daston GP. Leydig cell hyperplasia and adenoma formation: mechanisms and relecanceto humans. Reprod Toxicol 1997; 11 (1): 107-21.
[42] Ulbright TM, Amin MB, Young RH. Tumors of the testis, adnexa, spermatic cord and scrotum. In Rosai J. Atlas of Tumor Pathology, 3° Series. Washington, Dc Armed Forces Institute of Pathology, 1999.
[43] Santoja C, Varona C, Burgos FJ, Nistal M. Leydig cell tumors of the testis with adipose metaplasma. Appl Pathol. 1989; 7 (3): 201-4.
[44] Ulbright TM, Sriley JR, Hatzianastassiou DK, Young RH. Leydig cell tumors of the testis with unusual features: adipose differentiation, calcification with ossification and spindle-shaped tumor cells. Am J Surg Pathol. 1999; 23 (: 546-51.)
[45] Billings SD, Roth LM, Ulbright TM. Microcystic Leydig cell tumors mimicking yolk sac Richmond I, Banerjee SS, Eyden BP, Sissons MC. Sarcomatoid Leydig cell tumor of testis. Histopathology. 1995; 27 (6): 578-80.
[46] Sato K, Ueda Y, Sakurai A, Ishikawa Y, Okamoto SY, Ikawa H,
Katsuda S. Large cell calcifying Sertoli cell tumor of the testis:
comparative immunohistochemical study with Leydig cell tumor. Path Int. 2005; 55 (6): 366-71.
[47] Richmond I, Banerjee SS, Eyden BP, Sissons MC. Sarcomatoid Leydig cell tumor of testis. Histopathology. 1995; 27 (6): 578-80.
[48] Iczkowski KA, Bostwick DG, Roche PC, Chville JC. Inhibin A is sensitive and specific marker for testicular sex cord-stromal tumors. Mod Pathol. 1998; 11 (8): 774-9.
[49] Kommos F, Olia E, Bittinger F, Kirkpatrick CJ, Amin MB, Bhan AK,
Young RH, Scully RE. Inibin–alpha CD99, HEA 125, PLAP and
chromogranin immunoreactivity in testicular neoplasm and the androgen insensitivity syndrome. Human Path. 2000; 31 (9): 1055-61.
[50] Richi M, Howard LN, Bratthauer GL, Tavassoli FA. Use of monoclonal antibody against human inhibin as a marker for sex cord stromal tumors of the ovary. Am Surg Pathol. 1997; 21 (5): 583-9.
[51] Gordon MD, Corless C, Renshaw AA, Beckstead J. CD99, keratin and vimentin staining of sex cord-stromal tumors, normal ovary and testis. Mod Pathol. 1998; 11 (8): 769-73.
[52] Hekimgil M, Altay B, Yakut BD, Soydan S, Ozyurt C, Killi R. Leydig cell tumour of the testis: comparison of histopathological and immunoistochemical features of three azoozpermic cases and one malignant case. Int Pathol. 2001; 51 (10): 792-6.
[53] Oosterhuis JW, Kersemaekers AM, Jacobsen GK, Timmer A,
Steyerberg EW, Molier M, Morphology of testicular parenchyma adjacent
to germ cell tumours. An interim report. APMIS. 2003; 111 (1): 32-40. [54] Allen FJ, Van Vallenhoven F. Leydig cell tumor of intra-abdominal testis. Urology 1993; 42 (6): 729-31.
[55] Nistal M, Santamaria L, Paniagua R. Quantitative and ultrastructural study of Leydig cells in Klinefelter’s sindrome. J Pathos. 1985; 146 (4): 323-31.
[56] Cheville JC, Sebo TJ, Lager DJ, Bostwick DG, Farrow GM. Leydig cell tumour of testis: a clinicopathologi, DNA content and MIB-1
comparison of nonmetastazing and metastisizing tumours. Am J Surg Pathol. 1998; 22 (11): 1361-7.
[57] Chen KT, Spaulding RW, Flam MS, Brittin GM. Malignant interstitial cell tumour of the testis. Cancer. 1982; 49 (3): 547-52.
[58]Robert J. Motzer, George J Bosl. Cancro del testicolo. In: Harrison –
Principi di medicina interna 15° ed, McGraw-Hill, 2202, 726-730.
[59] Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol 2003; 170 (1): 5-11
[60] Rubio Tortosa I, Guanter VR, Garcias Torreles M et al. Tumor de células de Leydig: nuestros casos y revisiòn de la literatura. Arch Esp Urol. 2006 ; 59 (5) ; 467-72.
[61] Grem JL, Robins HI, Wilson KS, Glichrist K, Trump DL. Metastatic Leydig cell tumour of the testis. Report of three cases and review of the literature. Cancer 1986; 58 (9): 2116-9.
[62] Tamoney HJ Jr, Noriega A. Malignant interstitial cell tumor of the
testis. Cancer 1969; 24 (3): 547-51.
[63] Gulbahce HE, Lideland AT, Engel W, Lillemoe TJ. Metastatic Leydig
cell tumour with sarcomatoid differentiation. Arch Pathol Lab Med. 1999; 123 (11): 1104-7.
[64] Van Der Hem KG, Boven E, Van Hennik MB, Pinedo HM. Malignant Leydig cell tumour of the testis in complete remission on o,p’-dichlorodiphenil-dichloroethane. J Urol. 1992; 148 (4): 1256-9.
[65] Farkas LM, Szekely JG, Pusztai C, Baki M. High frequency of metastatic Leydig cell testicular tumors. Oncology. 2000; 59 (2): 118-21. [66] Mosharafa AA, Foster RS, Bihrie R, Koch MO, Ulbright TM, Einhom LH, Donohue JP. Does retroperitoneal lymph node dissection have a
curative role for patients with sex cord-stromal testicular tumours?. Cancer 2003; 98 (4): 753-7
[67] Wegner HE, Dieckmann KP, Herbst H, Andersen R, Miller K. Leydig cell tumour. Comparison of results of radical and testis sparing surgery in a single center. Urol Int. 1997; 59: 170
[68] Ulbright TM, Amin MB, Young RH. Tumors of the testis, adnexa, spermatic cord and scrotum. In Rosai J. Atlas of Tumor Pathology, 3° Series. Washington, Dc Armed Forces Institute of Pathology, 1999.
[69] Santoja C, Varona C, Burgos FJ, Nistal M. Leydig cell tumors of the testis with adipose metaplasma. Appl Pathol. 1989; 7 (3): 201-4.
[70] Clegg ED, Cook JC, Chapin RE, Foster PM, Daston GP. Leydig cell hyperplasia and adenoma formation: mechanisms and relevance to humans. Reprod Toxicol 1997; 11 (1): 107-21.
[71] Albers P., Albrecht W., Algaba F., Bokemeyer C., Cohn-Cedermark.,
Pizzocaro G. Guidelines on Testicular Cancer. European Association of
Urology 2006; 4-24.
[72] Wegner HE, Dieckmann KP, Herbst H, Andresen R, Miller K. Leydig cell tumour - comparison of results of radical and testis sparing surgery in a single center. Urol Int 1997;59:170-173.
[73] Droupy S, Mawlawi H, Izard V, Fabre E, Hammoudi Y, Eschwege P
et al: Tumourectomy for the treatment of Leydig cell tumours of the testis.
[74] Kim I, Young RH, Scully RE. Leydig cell tumours of the testis. A clinicopathological analysis of 40 cases and review of the literature. Am J Surg Pathol 1985;9:177.
[75] Cheville JC, Sebo TJ, Lager DJ, Bostwick DG and Farrow GM: Leydig cell tumor of the testis: a clinicopathologic, DNA
content, and MIB-1 comparison of nonmetastasizing and metastasizing tumors. Am J Surg Pathol 1998; 22: 1361.
[76] Carmignani L, Salvioni R, Gadda F, Colecchia M, Gazzano G, Torelli
T et al: Long-term followup and clinical characteristics
of testicular Leydig cell tumor: experience with 24 cases. J Urol 2006; 176: 2040.
[77] Elert A, Olbert P, Hegele A, Barth P, Hofmann R and Heidenreich
A: Accuracy of frozen section examination of testicular tumors of uncertain
origin. Eur Urol 2002; 41: 290.
[78] Miller DC, Peron SE, Keck RW and Kropp KA: Effects of hypothermia on testicular ischemia. J Urol 1990; 143: 1046.
[79] Carmignani L, Gadda F, Gazzano G, Nerva F, Mancini M, Ferruti M
et al: High incidence of benign testicular neoplasm diagnosed by
ultrasound. J Urol 2003; 170: 1738.
[80] Sheynkin YR, Sukkarieh T, Lipke M, Cohen HL and Schulsinger DA: Management of non palpable testicular tumors. Urology 2004; 63: 1163.
[81] Connolly SS, D’Arcy FT, Bredin HC, Callaghan J and Corcoran MO: Value of frozen section analysis with suspected testicular malignancy. Urology 2006; 67: 162.
[82] Powell TM and Tarter TH: Management of non palpable incidental testicular masses. J Urol 2006; 176: 96.
[83] Tokuc R, Sakr W, Pontes JE and Haas GP: Accuracy of frozen section examination of testicular tumors. Urology 1992; 40:512.
[84] Leroy X, Rigot JM, Aubert S, Ballereu C and Gosselin B: Value of frozen section examination for the management of nonpalpable incidental testicular tumors. Eur Urol 2003; 44:458.
[85] Huddart RA, Norman A, Moynihan C, Horwich A, Parker C, Nicholls
E et al: Fertility, gonadal and sexual function in survivors of testicular
cancer. Br J Cancer 2005; 93: 200.
[85] Steiner H, Müller T, Akkad T, Gozzi C, Neyer M and Bartsch G: Organ-sparing surgery in small testicular tumours does not lead to development of antisperm antibodies. Eur Urol, suppl., 2006; 5: 98.
[86] Heidenreich A, Weissbach L, Holtl W, Albers P, Kliesch S, Kohrmann
KU et al: Organ sparing surgery for malignant germ cell tumor of the
testis. J Urol 2001; 166: 2161.
[87] Maizlin ZV, Belenky A, Kunichezky M, Sandbank J and Strauss S: Leydig cell tumors of the testis: gray scale and color Doppler sonographic appearance. J Ultrasound Med 2004; 23: 959.
[88] Zarrilli S, Lombardi G, Paesano L, Di Somma C, Colao A, Mirone V
et al: Hormonal and seminal evaluation of Leydig cell tumour patients
before and after orchiectomy. Andrologia 2000; 32: 147.
[89] Gulbahce HE, Lindeland AT, Engel W and Lillemoe TJ: Metastatic Leydig cell tumor with sarcomatoid differentiation. Arch Pathol Lab Med 1999; 123: 1104.
