Precocious Pseudo-Puberty with Testicular Enlargement: Two Cases of Leydig Cell Tumor with Different Histopathological Results
Received 4 September 2020
Accepted for publication 2 November 2020
Published 23 November 2020 Volume 2020:12 Pages 577—582
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Jan Colli
Trahmono,1 Irfan Wahyudi,1 Arry Rodjani,1 Gerhard Reinaldi Situmorang,1 Nanis Sacharina Marzuki2
1Department of Urology, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 2Bunda Jakarta Hospital, Jakarta, Indonesia
Correspondence: Irfan Wahyudi
Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Kenari, Senen, Central Jakarta, Indonesia
Introduction: Leydig cell tumors (LCT) are the most common hormone-secreting testicular tumors; it is a rare cause for precocious pseudo-puberty in boys. The tumors secrete high amounts of testosterone. We present two cases of LCT in prepubertal boys presenting with precocious puberty.
Case Reports: Case 1. A 6-year-old boy was referred from the pediatric department with a diagnosis of precocious puberty. The patient had reported enlarged and painless swelling of the left testicle from a year ago. The puberty status of the patient was A1P3G4. Ultrasonography examination had found left testicular mass. Elective radical orchiectomy of the left testicle was performed. Histopathological analysis confirmed the diagnosis of benign LCT. Case 2. A 6-year-old boy presented with an enlarged left testicle for the last three months. Features of puberty were noted on the patient (appearance of pubic and facial hair). The puberty status of the patient was A1P3G3. Left testicle US had found homogenous, hypoechoic mass with calcification. Bone age had found increased bone maturation. Increased androgen hormones were detected through a blood test. Radical orchiectomy of the left testicle was performed. The histopathological examination showed malignant LCT.
Conclusion: Leydig cell tumors uncommonly occur in children. Prepubertal-aged boys presented with asymmetrical, firm, painless testicular enlargement with signs of puberty should be evaluated for LCT. Histopathological analysis is the mainstay of diagnosis and radical orchiectomy is the treatment of choice of LCT.
Keywords: precocious pseudo-puberty, Leydig cell tumor, orchiectomy
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