Isosexual Precocious Pseudopuberty Secondary to a Testosterone-Secreting Leydig Cell Testicular Tumor: True Isosexual Development Early After Surgery

April 2009 in “ Andrologia ”

T. Criscuolo, A. A. Sinisi, Lorena Perrone, Manuela Graziani, Antonio Bellastella, M Faggiano

testosterone dihydrotestosterone androstenedione dehydroepiandrosterone 17-hydroxyprogesterone ACTH dexamethasone HCG gonadotropin LRH TSH prolactin FSH LH DHT DHEA

TLDR A boy's early puberty caused by a testicular tumor returned to normal after surgery.

The paper described a case of a 6-year-old boy with isosexual precocious pseudopuberty caused by a testosterone-secreting Leydig cell testicular tumor. The boy exhibited high levels of testosterone, dihydrotestosterone, androstenedione, dehydroepiandrosterone, and 17-hydroxyprogesterone, which were unresponsive to ACTH, dexamethasone, or HCG administration. Gonadotropin levels were subnormal and did not respond to LRH stimulation, while TSH and prolactin levels were normal. After the tumor was surgically removed, the hormonal profile returned to prepubertal levels and remained normal for 6 months. The patient then entered puberty spontaneously at 7 years and 6 months, with normal pubertal basal and LRH-stimulated FSH and LH levels, and a pubertal circadian rhythm of gonadotropins and testosterone.

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