Steering Clear of Incorrect Laboratory Reference Ranges in Leydig Cell Testicular Tumor–Induced Peripheral Precocious Puberty: A case report

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.