Only 3% of testicular tumors originate from the Leydig cells; 90% of these are benign and usually produce steroid hormones.127,128 Consequently, symptoms such as gynecomastia and precocious puberty can be seen. Treatment consists of surgical enucleation in children and orchiectomy in adults (in children, tumors are usually benign, but in adults 10% to 15% seem to progress to malignancy). In cases of malignancy, the staging procedures outlined earlier should be applied. No large series of chemotherapy or radiotherapy have been published, and the few available reports indicate lack of efficacy of both these treatment modalities.