Excess androgen production

The increased growth rate seen in this child could also raise the possibility of growth hormone excess (i.e., a pituitary lesion). However, the appearance of secondary sexual features and a well-proportioned muscular build suggests an androgen effect. These androgens could be derived either from the testes or adrenal glands. The testes are small for the level of physical development of the child, suggesting an adrenal source of steroids.