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Pathology for Urologists

Precocious Puberty


  • Familial testotoxicosis: autosomal dominant condition in which Leydig cells differentiate early resulting in spermatogenesis in absence of pituitary hormonal stimulation (i.e., this is a primary testicular disorder).
  • Congenital Leydig cell hyperplasia: thought to result from high levels of HCG especially as seen in diabetic moms; usually resolves on its own within first month of life; two types have been described:
    • Diffuse: requires morphometric quantitation.
    • Nodular: unencapsulated nodule of Leydig cells - usually does not cause precocious puberty.
  • Leydig cell tumor: neoplastic Leydig cells secrete testosterone, resulting in maturation of adjacent seminiferous tubules; since this is predominantly a local effect, quite often the opposite testis is normal.
  • McCune-Albright syndrome: testicular maturation before 9 years of age caused by steroid secretion by the testis, resulting in early maturation of hypothalamic-pituitary-testicular axis.
  • Other: FSH-secreting pituitary adenomas, hypothyroidism, von Recklinghausen's syndrome, etc.

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