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Atypical presentation of Leydig cell tumour in three prepubertal patients: diagnosis, treatment and outcomes

  • Miriam García González ORCID logo EMAIL logo , Isabel Casal-Beloy , Iván Somoza Argibay and Teresa Dargallo Carbonell

Abstract

Background

Testicular tumours are uncommon in children, accounting for only 1% of all childhood tumours. Prepubertal Leydig cell tumours actively secrete testosterone and as a result, patients typically present with isosexual precocious pseudopuberty, this being the first cause of consultation. We present three cases of Leydig cell tumours in prepubertal patients with an atypical presentation.

Methods

We studied three cases of Leydig cell tumours in prepubertal boys, who either consulted for testicular asymmetry or were incidentally found to have the tumour in the absence of systemic signs of systemic hyperandrogenism or precocious puberty. In all cases, a well-circumscribed testicular mass was found by testicular ultrasound. The diagnosis was confirmed by histology. In all three cases, testicular enucleation was performed with satisfactory follow-up.

Results

Following the surgical procedure, during the follow-up, all patients showed a normal testicular volume in comparison with the contralateral testis. No complications were seen during follow-up.

Conclusions

A testicular ultrasound in children developing asymptomatic testicular asymmetry might be recommended due to its possible hormonal action locally. An early testicular ultrasound, testicular swelling discrepancies, tumour size and androgen production are key factors in the prognosis and management of this type of tumour.


Corresponding author: Miriam García González, MD, PhD, Department of Paediatric Surgery, Section of Paediatric Urology, Hospital Materno-Infantil Teresa Herrera, Complexo Hospitalario Universitario de A Coruña (CHUAC), As Xubias s/n, 15006 A Coruña, Spain, Phone: 0034-651367338, E-mail:

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-10-29
Accepted: 2019-01-30
Published Online: 2019-03-15
Published in Print: 2019-04-24

©2019 Walter de Gruyter GmbH, Berlin/Boston

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