Endocrine Abstracts

JOINT2258

Introduction: Advanced bone age (BA) is frequently observed in patients with Leydig cell tumors (LCTs) due to increased testosterone secretion, leading to an adult height (AH) below the average for the normal population. Estrogen is the principal regulator of epiphyseal fusion in both males and females, accelerating growth plate closure. Aromatase inhibitors (AIs) have been used to enhance linear growth in boys with advanced BA and poor height potential. We present a patient with an LCT treated with an AI.

Case Report: An 11.5-year-old boy, previously healthy, was referred following an orchiectomy for an LCT in the left testicle. His height was 150.5 cm (0.71 SDS), with a mid-parental height of 171.75 cm (-0.2 SDS). His BA was 14 years (2.25 years advanced), with a predicted adult height (PAH) of 163 cm (-1.44 SDS). Tanner stage was 4 (G4, PH4), and right testicular volume was 15 mL. Laboratory results: LH: 3.7 IU/l, FSH: 12.4 IU/l, E2: 43 pg/ml, Testosterone: 4.24 ng/ml. Treatment with anastrozole, 1 mg/day, was initiated to optimize his final height. At the last visit, after 18 months of treatment (at 13.58 years old), his height was 162 cm (0.7 SDS), his BA was 15.5 years (2 years advanced), and his PAH was 167 cm (-0.8 SDS). Treatment was discontinued at this time.

Conclusions: Treatment with aromatase inhibitors decelerates epiphyseal fusion, prolonging the growth period and consequently improving adult height. In this case, treatment with an AI for 18 months resulted in an improvement in PAH. Long-term follow-up is required to evaluate whether the final height corresponds to the predicted height.