A 11--year-old boy with an hCG-secreting hepatoblastoma.
Note the outline of the large liver (a) and the penile enlargement (b). The testes were each 1 cm, and pubic hair was at stage 2. The plasma hCG level was 30 miu/ml, plasma testosterone 168ng/dl, and plasma a-fetoprotein 160,000ng/ml. Metastatic lesions in both lungs were seen on the chest X-ray. Reproduced from Kaplan and Grumbach (1990), by courtesy of Williams and Wilkins.