Familial Male-limited Precocious Puberty (FMPP) and Testicular Germ Cell Tumors

Cezanne D. Kooij, Annelies M.C. Mavinkurve-Groothuis, Idske C.L. Kremer Hovinga, Leendert H.J. Looijenga, Tuula Rinne, Jacques C. Giltay, Laetitia M.O. de Kort, Aart J. Klijn, Ronald R. de Krijger, Annemarie A. Verrijn Stuart

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)


OBJECTIVE: The purpose of this study is to report development of a malignant testicular germ cell tumor (GCT) in 2 young adult males with familial male-limited precocious puberty (FMPP) because of LHCGR pathogenic variants in 2 families. Secondarily, to study the possible relation between FMPP and testicular tumors and to investigate whether FMPP might predispose to development of malignant testicular tumors in adulthood a literature review is conducted. METHODS: Data on 6 cases in 2 families are obtained from the available medical records. In addition, a database search is performed in Cochrane, PubMed, and Embase for studies that report on a possible link between FMPP and testicular tumors. RESULTS: The characteristics of 6 males with FMPP based on activating LH receptor (LHCGR) germline pathogenic variants are described, as are details of the testicular GCTs. Furthermore, a literature review identified 4 more patients with signs of FMPP and a (precursor of) testicular GCT in adolescence or adulthood (age 15-35 years). Additionally, 12 patients with signs of precocious puberty and, simultaneously, occurrence of a Leydig cell adenoma or Leydig cell hyperplasia are reported. CONCLUSION: There is a strong suggestion that FMPP might increase the risk of development of testicular GCTs in early adulthood compared with the risk in the general population. Therefore, prolonged patient monitoring from mid-pubertal age onward including instruction for self-examination and periodic testicular ultrasound investigation in patients with a germline LHCGR pathogenic variant might contribute to early detection and thus early treatment of testicular GCT.

Original languageEnglish
Pages (from-to)3035-3044
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Issue number11
Publication statusPublished - 23 Nov 2022


  • activating luteinizing hormone receptor
  • familial male limited precocious puberty
  • germ cell tumors
  • peripheral precocious puberty
  • testicular tumors
  • testotoxicosis


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