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  #1  
Old 01-05-2012
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Default male repro concept

Leydig cell tumor of testes is androgen producing and causes gynaecomastia in men.

the only reason i can think is peripheral conversion to estrogen ?
but i m confused

can somebody pls exaplain why it causes gynaecomastia?
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Old 01-05-2012
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High levels of Androgen are converted peripherally to estrogen
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Old 01-05-2012
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I agree hormone imbalance

Quote:
Originally Posted by step_enhancer View Post
Leydig cell tumor of testes is androgen producing and causes gynaecomastia in men.

the only reason i can think is peripheral conversion to estrogen ?
but i m confused

can somebody pls exaplain why it causes gynaecomastia?
Gynecomastia is due to the imbalance of Testosterone and Estrogen levels. Normally, the ratio of T to E synthesis is 100:1, ratio of T to E concentration in the circulation is 300:1. The imbalance may be due to increased synthesis of estrogen, decreased synthesis of testosterone, or increased conversion of T to E. Also, consider hypogonadism, increased hCG, increased thyroxine, cirrrhosis, kidney failure, or the use of spironolactone, furosemide+digoxin, ...

Testicular cancer can be divided into germ cell tumor (such as seminoma, yolksac tumor) and sex cord- gonadal stromal tumors (such as Leydig,Sertoli tumors). When it reads gynecomastia due to testicular cancers, that is due to the excess b-hCG and estrogen production by germ cell tumors. On the other hand, testosterone secreting tumor like Leydig and Sertoli cell tumors cause a high level of T, leading to masculinization in women and precocious puberty in boys. (Please check if you are sure that Leydig cell tumor causes gynecomastia ). Aromatase enzyme abundant in skin, muscle and fat can convert T to E peripherally and shift the balance towards estrogen, esp in obese old men.

Effects of drugs:
-steroid use, exogenous testosterone...enhance estrogen synthesis.
-spironolactone, ketoconazole, metronidazole, cimetidine, finasteride, alkylating agents, cisplatin: inhibit synthesis of testosterone
-ACEI, CCB, TCA, diazepam, omeprazole: unknown mechanisms.
Treatment: estrogen receptor antagonist, such as clomifen and tamoxifen, that block the effect of estrogen in the breast.

Please correct me, so that we can all learn things.
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Old 01-05-2012
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@patho 2012

yes pretty much explains everything.thanks a lot
yes leydig cell tumor of testes produce androgens.
i checked up in Harrison testosterone have three pathways 1)converted to DHT
2)peripherally convert to estrogen 3)don rememeber

thanks for nice explanation.i needed to sum up these concepts .i just thought its paradoxical to find androgen producing tumor to cause gynaecomastia.
but now its clear.

and also note marijuana causes gynaecomastia my friend had this in his step 1 exam ....
perfect eg of -little points in FA that we take for granted
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Old 01-05-2012
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According to Kaplan LNs and USMLEWORLD Leyding cell tumors may produce androgens (hence precocious puberty and masculinization in children) AND estrogens ( hence gynecomastia in adults) or rarely corticosteroids.

An extra-piece of information:
Grossly :these tumors R homogenous and golden brown(steroids)
Microscopically: large polygonal cells with indistinct cell boundaries , ROD-SHAPED CRYSTALS(OF REINKE)
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  #6  
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Originally Posted by step_enhancer View Post
@patho 2012



and also note marijuana causes gynaecomastia my friend had this in his step 1 exam ....
and heroin , together with laxative abusing
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