Background: Intratubular Large Cell Hyalinizing Sertoli Cell Neoplasia (ITLCHSCN) resulting from Sertoli cells of the testis are mainly reported in young adults and these are rarely seen in childhood.
Objective and hypotheses: In this case report, an eight-and-a-half-year old case presenting with complaint of bilateral gynecomastia since two years, showing no endocrine abnormality in laboratory during 2-years of follow-up, determined to have progression in bilateral gynecomastia, increase in testicular volumes, advanced bone age, increase in growth velocity in the clinical follow-up.
Method: A six-and-a-half-year old male presented with complaint of pain, induration and enlargement of his breasts for three months. Hormonal values were determined as in normal range (prepubertal). Tumor markers were negative. Bone age was consistent with 6 years of age. The scrotal sonography showed hyperechogenicity consistent with testicular microlithiasis in bilateral testes. An increase in the size of his gynecomastia was detected during two years of follow-up. His bone age was consistent with 9 years of age while chronological age was eight-and-a-half-year of age. At the second year of his following, since basal LH value was detected to be higher and an increase was determined in testicular volumes, LH-RH test was performed. The results were consistent with prepubertal response.
Results: Due to determination of increase in growth velocity, advanced bone age and progression in gynecomastia, a testicular biopsy was performed due to suspicion of malignancy. Pathological examination was reported to be consistent with ITLCHSCN.
Conclusion: Progression of gynecomastia in a boy with increase in growth velocity, advanced bone age, increase in testicular volume as well as presence of microlithiasis in the testicles should suggest Sertoli Cell Tumors (SCTs).
10 - 12 Sep 2016
European Society for Paediatric Endocrinology