Frontiers in Pediatrics (Nov 2015)

True precocious puberty following treatment of a Leydig cell tumour: two case reports and literature review

  • Alberto eVerrotti,
  • Laura ePenta,
  • Letizia eZenzeri,
  • Laura eLucchetti,
  • Paolo eGiovenali,
  • Pierpaolo eDe Feo

DOI
https://doi.org/10.3389/fped.2015.00093
Journal volume & issue
Vol. 3

Abstract

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Leydig cell testicular tumours are a rare cause of precocious pseudopuberty in boys. Surgery is the main therapy and shows good overall prognosis. The physical signs of precocious puberty are expected to disappear shortly after surgical removal of the mass. We report two children, 7.5 and 7.7 year-old boys, who underwent testis-sparing surgery for a Leydig cell testicular tumour causing precocious pseudopuberty. During follow-up, after an immediate clinical and laboratory regression, both boys presented signs of precocious puberty and ultimately developed central precocious puberty. They were successfully treated with gonadotropin releasing hormone analogues. Only 6 other cases have been described regarding the development of central precocious puberty after successful treatment of a Leydig cell tumour causing precocious pseudo puberty. Gonadotropin-dependent precocious puberty should be considered in children treated for a Leydig cell tumour presenting persistent or recurrent physical signs of puberty activation. In such cases, therapy with gonadotropin releasing hormone analogues appears to be the most effective medical treatment.

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