Frontiers Journal of Case Reports and Images (FJCRI)

LEYDIG CELL TUMOR OF THE TESTIS; A RARE CAUSE OF FEMINIZATION (GYNECOMASTIA) IN A BOY

Keywords : Leydig Cell Tumor, Gynecomastia, Testicular Mass, Virilization

Abstract

Leydig cell tumors (LCT) are rare in childhood and account for 1-3% of all testicular tumors and 3-6% of testicular masses. Presentation can include endocrinological manifestation e.g. pubarche or precocious puberty; rarely, gynecomastia. We report a 7-year-old boy who presented with a right testicular mass with an 8-month history of breast enlargement, pubic hair and accelerated growth. Physical examination revealed a tall boy (height: 146.4cm, +5.5 SD), with bilateral breast enlargement (Tanner 3-4) and a firm enlarged right testis, pubarche (Tanner 2) and a stretched penile length of 9 cm. Scrotal ultrasound revealed an enlarged right testis measuring 3.5 x 2.2 cm with an ill-defined heterogenous lesion with dense calcifications measuring 2.5 x 1.5 cm. Serum estradiol and testosterone were elevated, with prepubertal levels of gonadotropins. He underwent a right radical orchiectomy and histopathology revealed a benign Leydig cell tumor. Post operatively, serum estradiol and testosterone levels declined.

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