LCCSCTLarge-Cell Calcifying Sertoli Cell Tumor
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In patients with PJS, however, endocrinological findings such as prepubertal gynecomastia might be indicative of a testicular tumor, namely, LCCSCT. Malignancy is found in approximately 17% of patients with LCCSCT but is rare in young patients with bilateral tumors or in association with a genetic syndrome including PJS (10).
In our patient, a prior diagnosis of PJS, presence of prepubertal gynecomastia of recent onset, and appearance of bilateral coarse calcifications in scrotal USG were the factors suggestive of a diagnosis of LCCSCT.
For the purpose of avoiding such complications, anastrozole treatment was initiated for LCCSCT without performing a biopsy.
Anastrozole treatment was reported to be effective in achieving control over clinical findings of LCCSCT cases with gynecomastia (2,9,12).
Although elevated estradiol levels may be helpful in the diagnosis, these levels are not necessarily increased in all LCCSCT cases, as was the case in our patient (9).
In cases with PJS who develop LCCSCT, elevated aromatase activity not only causes gynecomastia but also leads to other undesired effects such as increased rates of linear growth and bone maturation (1,2,3,7,8,9).