Prepubertal gynaecomastia in association with an interstitial-cell tumour of the testis.

Abstract

SUMMARYA case of interstitial–cell tumour of the testis with pre–pubertal gynecomastia is described. The literature is reviewed and it is noted that only five of the 39 reported cases showed evidence of gynecomastia, although every case had features of precocious virilism. The danger of confusing bilateral testicular adrenal rests with interstitial–cell tumours of the testis and the diagnostic safeguards are mentioned. Malignancy has not been reported in any of these prepubertal tumours but can be excluded only by prolonged observation. The 17–ketosteroid and oestrogen excretions in this case are given, with reservations. It has been assumed that an excess of oestrogen is the cause of gynecomastia. The mechanisms of this excess production are mentioned. It is suggested that excess oestrogen might modify the psycho–sexual effects but not the physical effects of this virilising tumour.I wish to thank Dr W. J. Maelor Evans, Chief Medical Officer, Ministry of Health, Tanzania, for having given permission to publish this paper. I am greatly obliged to Drs P. Grech and P. J. Philip for their very considerable help and I wish to express my sincere thanks to them. My thanks also go to Drs J. Hamerton and M. T. Maletnlema for the photographs and to my House Surgeon, Dr G. A. S. Kombe for his assistance. 1 also wish to thank the laboratory staff of the Muhimbili Hospital who undertook the urinary steroid estimations whilst coping with a welter of routine work.