PMC7695686_01
Acne and facial hair (A) and enlarged penis with scant pubic hair (B) in a 6-year-old boy, showing signs of precocious pseudo-puberty as shown on both cases. Advanced bone age of Case 2 (C).
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The pubertal state of the patient was A1P3G3-4 (see Table 1, Figure 1). 
Ultrasound of the testicles of Case 1 (A) and Case 2 (B).
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Abnormal left testicle was revealed on US and MRI, while bone age was advanced in X-ray (see Table 1, Figure 2B).
Macroscopic anatomy findings of the left testis from the patient of Case 1 (A) and Case 2 (B). Note a well circumscribed yellowish-brownish mass inside the testis.
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The excised left testicle had dimensions of 8.5 x 3 x 2.5 cm with a brownish color, firm, and smooth surface mass inside the testis (see Figure 3B).
(A) The tumor mass was lobulated had indistinct border; (B) spherical nuclei of tumor cells, pleomorphic, granulated eosinophilic cytoplasm, (high power field, 400x); (C) Reinke crystal. (D) Solid tumors formed nest.
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The histopathological examination had revealed tumor mass forming a nest (separated by fibrovascular septa); polygonal shape; pleomorphic; coarse chromatin; eosinophilic; and active mitosis in more than 3 out of 10 cells (in high power field) (see Figure 4D).
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Ultrasound of the testicles of Case 1 (A) and Case 2 (B).
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Abnormal left testicle was revealed on US and MRI, while bone age was advanced in X-ray (see Table 1, Figure 2B).
Macroscopic anatomy findings of the left testis from the patient of Case 1 (A) and Case 2 (B). Note a well circumscribed yellowish-brownish mass inside the testis.
RRU-12-577-g0003.jpg
PMC7695686_02_RRU-12-577-g0003.jpg
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The excised left testicle had dimensions of 8.5 x 3 x 2.5 cm with a brownish color, firm, and smooth surface mass inside the testis (see Figure 3B).
(A) The tumor mass was lobulated had indistinct border; (B) spherical nuclei of tumor cells, pleomorphic, granulated eosinophilic cytoplasm, (high power field, 400x); (C) Reinke crystal. (D) Solid tumors formed nest.
RRU-12-577-g0004.jpg
PMC7695686_02_RRU-12-577-g0004.jpg
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The histopathological examination had revealed tumor mass forming a nest (separated by fibrovascular septa); polygonal shape; pleomorphic; coarse chromatin; eosinophilic; and active mitosis in more than 3 out of 10 cells (in high power field) (see Figure 4D).