Progression from Peripheral to Central Precocious Puberty in a Child with Leydig Cell Tumor.

An 8-y-old boy presented with premature virilization and was found to have peripheral precocious puberty due to a unilateral Leydig cell tumor. The mass was surgically excised, and histopathology confirmed the diagnosis. Postoperatively, androgen levels normalized; however, within months, he developed accelerated growth, testicular enlargement, and rising gonadotropins, consistent with central precocious puberty. Treatment with a gonadotropin releasing hormone analogue stabilized pubertal progression. This case underscores the need to consider Leydig cell tumors in boys with early virilization and highlights the risk of central activation even after curative surgery. Vigilant long-term follow-up is crucial for timely recognition and management to optimize growth and psychosocial outcomes.