No aggression in a 4-year-old boy with an androgen-producing tumour: Case Report

In this case report a 4-year-old boy is described whose testosterone and dehydroepiandrosterone sulphate (DHEA-S) levels were raised to pubertal levels due to a testosterone producing testis tumour. This provided the unique opportunity to examine the effects of elevated levels of androgens on levels of aggression or on social dominance before the onset of puberty.The present case report does not support the hypothesis of a causal relationship between testosterone and aggression or between testosterone and social dominance in young children.The androgen testosterone plays a critical role in many aspects of sexual differentiation. Also, it is thought to induce aggressive behaviours. Results of animal studies have indicated that, in most species, androgens, including testosterone, facilitate aggressive behaviour [1-5]. However, studies that investigated associations between androgens and aggression in humans have yielded inconclusive results and are very difficult to compare due to methodological differences. Moreover, most studies have compared hormone levels in individuals with high versus low aggression levels, or have yielded correlations between testosterone levels and the extent of aggression, which makes inferences about a causal relationship impossible. Furthermore, little is known about the relation between testosterone levels and the aggressive behaviour in pre-adolescent children. Because in normal development, testosterone levels are very low from the age of 6 months until pre-puberty, most studies have used samples that consisted of pubertal and post pubertal males. More recent studies hypothesised there might be an association between testosterone and social dominance instead [6-8]. Because ethically it is impossible to set up experiments to respond to the question of causal relationships, we should rely on natural experiments.In the present report we describe the case of a 4-year-old boy whose testosterone and dehydroepiandrosterone sulphate (DHEA-S) lev