title: True Precocious Puberty Following Treatment of a Leydig Cell Tumor: Two Case Reports and Literature Review.
abstract: Leydig cell testicular tumors 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 tumor 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 (GnRH) analogs. Only six other cases have been described regarding the development of central precocious puberty after successful treatment of a Leydig cell tumor causing precocious pseudopuberty. Gonadotropin-dependent precocious puberty should be considered in children treated for a Leydig cell tumor presenting persistent or recurrent physical signs of puberty activation. In such cases, therapy with GnRH analogs appears to be the most effective medical treatment.
authors.affiliation: Department of Pediatrics, University of Perugia , Perugia , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
authors.affiliation: Department of Pediatrics, University of Perugia , Perugia , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Penta
authors.affiliation: Department of Pediatrics, University of Perugia , Perugia , Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Zenzeri
authors.affiliation: Department of Pediatrics, University of Perugia , Perugia , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Lucchetti
authors.affiliation: Department of Pathology, University of Perugia , Perugia , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giovenali
authors.affiliation: Department of Internal Medicine, University of Perugia , Perugia , Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: De Feo
keywords: GnRH analogs; GnRH stimulation test; Leydig cell tumor; precocious pseudopuberty; true precocious puberty