CLINICAL, MORPHOLOGICAL AND BIOCHEMICAL STUDIES OF A VIRILIZING TUMOR IN THE TESTIS*

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Abstract
An interstitial cell tumor of the testis in a highly virilized boy was studied for its morphologic and biochemical properties. Prior to surgery, the patient excreted high levels of androsterone and etiocholanolone, their 11-oxygenated derivatives and pregnanetriol. The Leydig cells showed crystalloids of Reinke. In vivo studies of the tumor revealed a normal androgen biosynthetic pathway in which 4-androstenedione and testosterone were produced, accounting for the highly virilizing properties of the tumor. The presence of the "adrenalcortical" enzyme, 11 [beta]-hydroxylase, in this tumor was observed, accounting for the elaboration of 11 [beta]-hydroxyandrostenedione, which in turn explains the high pre-operation levels of urinary 11-oxygenated 17-ketosteroids.