Leydig Cell Testicular Tumour Presenting as Isosexual Precocious Pseudopuberty in a 5 Year-old Boy

Abstract

Leydig cell testicular tumors are very rare in children and cause isosexual precocious puberty. We report on a 5-yr-old boy with a Leydig cell tumor of the test is presented with isosexual precocious puberty, penis enlargement, pubic hair, recent growth spurt with deeping of the voice and a seven years on his bone age. An elevated testosterone level 3.72 ng/mL. Right testicle ultrasound showed a hypoechoic nodule and right orchiectomy was performed.Keywords: Leydig-cell tumor; Testicular; Precocious puberty; Neoplasm; Testis normal puberty [1,2]. Precocious puberty can occur because of a disturbance in hypothalamic pituitary gonadal axis (which is called central precocious puberty), or a disturbance outside that axis (which is called peripheral precocious puberty) [3]. Testicular tumors are rare in pediatric patients with an incidence of 0.5-2/ 100,000 children and adolescents [4]. Leydig cell tumors are sex cord Stromal Tumors arising from Leydig cells that are interstitial cells that produce testosterone [5]. They represent the 1-3% of all tumors and more commonly found in adults between 40 and 50 years of age.Leydig cell tumors are universally benign during childhood. The majority of patients present between 5 and 10 yr of age, most commonly with precocious puberty [6]. Androgenization signs include prominent external genitalia, frequent erections, pubic and axillary hair, early growth spurt and deepening of the voice [7]. An elevated testosterone level with low or normal serum gonadotropin, FSH (follicle-stimulating hormone) and LH (luteinizing hormone), levels is consistent with Leydig cell tumor. Ultrasonography is necessary for diagnosis because it is sometimes difficult to detect on physical examination [8]. Leydig cell tumors should be treated by simple orchidectomy. Testissparing excision is a reasonable consideration when the volume of normal testicular tissue surrounding the mass is acceptable or the lesion is bilateral [9]. Case ReportA 5-yr-old boy was referred to the hospital for endocrinology pediatric evaluation of penis enlargement, pubic hair, axillary odor and recent growth spurt with deeping of the voice for over one year. The parents noticed a penis enlargement with pubic hair and frequent erections ( IntroductionPrecocious puberty is defined as the appearance of secondary sex characteristics at a younger age than in the general population, 8 year old in girls and 9 years old in boys as the lowest age of The levels of testosterone was 3.72 ng/ml, the levels of FSH and LH were prepuberal. Testicular Ultrasound showed right testicle measures: 24 x 13 x 18 mm, heterogeneous hypoechogenic nodule measuring 22 x 10 x 20 mm with peripheral vascularization suspicious of malignancy. Left testicle measures: 10 x 7 x 15 mm, homogeneous epididymis having cystic image of 2 x 2 mm.The chest x-ray and the abdominal -pelvic MRI were normal. Following referral to the Urology Team of the hospital, the patient underwent right radical inguinal orchidectomy and pathology examination of the right testi...

Precocious Puberty Associated with Testicular Hormone-secreting Leydig Cell Tumor

“…They are rare tumors with an incidence of 1%-3% of all testicular tumors [2] and represent only 1% of all solid tumors affecting children. There are 0.5-2 reported testicular tumors per 100,000 children and adolescents [3]. LCTs occur in about 3%-6% of pre-pubertal boys.…”