PSEUDOPRECOCIOUS PUBERTY DUE TO A VERY SM ALL LEYDIG-CELL TUMOR - ENDOCRINOLOGIC INVESTIGATIONS, DIFFERENTIAL-DIAGNOSIS AND PROBLEMS OF IMAGING MODALITIES

We report on a 8 2/12 year old boy with marked signs of precocious pub erty (height 134.4 cm, pubic hair Tanner stage III, bone age 13 3/12 y ears, mean serum testosterone concentration 6.6 nmol/l). The testicula r volume was only 2 ml. After having excluded congenital adrenal hyper plasia and true precocious puberty the differential diagnostic evaluat ion had to take into account a tumor of the adrenals secreting androge ns, a Leydig cell tumor, or a familial male limited precocious puberty . Despite repeated investigations of the testes a testicular tumor was revealed first only 14 month later. Histological examination showed a Leydig cell tumor. It must be stated retrospectively that the sonogra phic investigation which is of high diagnostic importance, needs a 7.5 MHz-scanner as a minimum to detect small testicular tumors. The MR Im aging has a higher sensitivity but low specifity.