Oncology (General Cancer)/Leydig tumor

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Question
Hello
My brother was diagnosed with testicular cancer. He only had one testicle as the other was what the doctor referred to as a nub. It was not developed. My brother is 57yrs old and is mentally handicapped. He has all the symptoms of Klinefelder syndrome but has yet to have a chromosone test. To get back to his testicular cancer he had the surgery to remove the tumor and I was told it was a rare tumor. A Leydig tumor and that they are 90% benign. My brother gets CT scans every 4 or 5 months and has been doing alright for the past year since the surgery until the last scan that showed a lymph node in his abdomen that is between the vena cava and aorta. He then had a PEt scan and the lymph node "lit" up. He has been referred to a cancer center. What does this mean? Did he develop cancer? Couldn't it be something else? Please write to me as soon as possible. He has alot of other health issues as well and takes a variety of medications including androgel. Thank you.

Answer
The positive node could be a lot of things -- inflammatory reaction being one.  However, the most likely thing would be recurrent cancer (or new cancer).  When a testicle is removed it is first examined by the pathologist, and then slices are taken for further examination.  It isn't unusual to see a tumor that appears reasonably benign because that was the part that was sampled.  It's also possible that the node in the abdomen reflects a different process.  At that age, prostate cancer and bladder cancer come to mind.   If he was my patient, I would do a fine needle aspirate of the node and then based on those results woul plan the rest of my diagnostic and therapeutic approach.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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