Leydig cell tumors are rare pediatric testicular neoplasms. We report a case of an 8-year-old boy who presented with early pubertal progression, including pubic hair and voice deepening, yet with biochemical results suggesting a prepubertal state. Normal testosterone levels and a flat Gonadotropin Releasing Hormone (GnRH) stimulation test response, bone age was advanced. Careful examination revealed asymmetric testicular size, and ultrasound identified right intratesticular lesion. Histopathology following unilateral orchiectomy confirmed a LCT. This case illustrates the diagnostic trap of relying solely on available laboratory reference ranges. It highlights the critical role of multidisplinary approach when laboratory data appear inconsistent.
Sawalha et al. (Sun,) studied this question.