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, Merih T Tesfazghi Rush University Medical Center , Chicago, IL Address correspondence to this author at: Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Chicago, IL 60612. Fax 314-362-1461; e-mail merih_tesfazghi@rush.edu. Search for other works by this author on: Oxford Academic Christopher W Farnsworth Washington University in St. Louis , St. Louis, MO Search for other works by this author on: Oxford Academic
Clinical Chemistry, Volume 65, Issue 1, 1 January 2019, Pages 210–211, https://doi.org/10.1373/clinchem.2018.291468
Published:
01 January 2019
Article history
Received:
28 April 2018
Accepted:
14 May 2018
Published:
01 January 2019
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Merih T Tesfazghi, Christopher W Farnsworth, Highest Testosterone Concentration Ever: Pathology or Laboratory Error?, Clinical Chemistry, Volume 65, Issue 1, 1 January 2019, Pages 210–211, https://doi.org/10.1373/clinchem.2018.291468
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Case Description
The laboratory obtained a testosterone result of 30117 ng/dL for a 51-year-old man and called the medical director to assess whether this value was feasible because it would represent the highest testosterone concentration ever reported by the laboratory. The patient was an avid runner with a history of a right testicular mass and orchiectomy 10 years previously. The patient was supplemented with testosterone cypionate (200 mg/2 weeks). The results for follicle-stimulating hormone and luteinizing hormone were unremarkable.
Questions
What conditions are associated with the extremely high testosterone concentrations?
Could exogenous testosterone account for this concentration?
If pathological, what is the prognosis for patients with this condition?
The answers are below.
Answer
Increased testosterone concentrations are seen in individuals with exogenous testosterone supplements and sex hormone–producing adrenal tumors. At supraphysiological doses, exogenous supplements could raise serum testosterone concentrations by approximately 2- to 6-fold (1–3). This patient had a metastatic Leydig cell tumor diagnosed 5 years postorchiectomy. Testosterone concentrations began to increase dramatically around this time (Fig. 1). Malignant Leydig cell tumor is refractory to chemotherapy and radiotherapy (4). The median survival time of patients with malignant Leydig cell tumor is 2 years (5).
The kinetics of peak total testosterone concentrations measured after radical right orchiectomy.
Fig. 1.
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Five years postorchiectomy, the tumor relapsed and extensively metastasized to the lung, liver, and retroperitoneum, requiring multiple surgeries.
Author Contributions:All authors confirmed they have contributed to the intellectual content of this paper and have met the following 4 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; (c) final approval of the published article; and (d) agreement to be accountable for all aspects of the article thus ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved.
Authors' Disclosures or Potential Conflicts of Interest:No authors declared any potential conflicts of interest.
References
1.
Bhasin S Woodhouse L Casaburi R Singh AB Bhasin D Berman N
Testosterone dose-response relationships in healthy young men
.
Am J Physiol Endocrinol Metab
2001
;
281
:
E1172
–
81
.
2.
Bhasin S Storer TW Berman N Callegari C Clevenger B Phillips J
The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men
.
N Engl J Med
1996
;
335
:
1
–
7
.
3.
Pope
HG
Jr,Kouri
EM
,Hudson
JI
.Effects of supraphysiologic doses of testosterone on mood and aggression in normal men: a randomized controlled trial
.
Arch Gen Psychiatry
2000
;
57
:
133
–
40
,
discussion 55–6
.
4.
Idrees MT Ulbright TM Oliva E Young RH Montironi R Egevad L
The World Health Organization 2016 classification of testicular non-germ cell tumours: a review and update from the International Society of Urological Pathology testis consultation panel
.
Histopathology
2017
;
70
:
513
–
21
.
5.
Al-Agha OM Axiotis CA
An in-depth look at Leydig cell tumor of the testis
.
Arch Pathol Lab Med
2007
;
131
:
311
–
7
.
© 2019 The American Association for Clinical Chemistry
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
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