Pseudo-precocious puberty in a male patient and the melatonin-testosterone relationship

We describe a 14 year-old boy with a pineal germ cell tumor which secreted beta HCG. Serum testosterone levels were markedly elevated with concomitant decreased LH secretion. 24-h serum melatonin levels were suppressed and lacked the normal nocturnal rise. Pineal radiation therapy was followed by tumor regression and the diminution of beta HCG stimulated testosterone, which in turn inhibited melatonin and LH. When beta HCG and testosterone were normalized after tumor radiation, a recovery of normal melatonin and LH secretory pattern occurred. These results indicate that circulating testosterone down-regulates pineal melatonin.