Cytology 3D structure formation based on optical microscopy images A N Pronichev, E V Polyakov, I P Shabalova et al. IntroductionCervical cancer is the second most common cancer in women worldwide [1]. In Indonesia, it is the leading cause of death among gynecological cancers.1Most patients with cervical cancer present at an advanced stage. With earlier detection, the incidence of mortality due to cervical cancer has been shown to decrease drastically. There are a number of methods to detect precancerous cervical lesions. These include visual inspections with acetic acid, cytological screening using the Papanicolaou (Pap) smear test, HPV DNA tests, and colposcopies. In many countries, the Pap test is routinely used to screen for cervical precancer. Published results, including those of a meta-analysis, showed that the sensitivity and specificity of the Pap test were 50-90% and 80-90%, respectively, whereas the sensitivity and specificity of liquid-based cytology were both 76%.2,3 The same research reported that the sensitivity and specificity of colposcopy were 70% and 44%, respectively [2,3]. The more recent HPV DNA test resulted in sensitivity and specificity of 90% and 86.5%, respectively [2,4]. Although the Pap test has been used for decades, the incidence of false negatives with this test is relatively high (10-50%) [5]. Thus, other investigations are necessary to improve its accuracy. The liquid-based cytology (e.g., ThinPrep) Pap test improves the detection of low-grade precancerous lesions. However, a clinical examination strategy for cervical cancer based on this test and follow-up colposcopies has a number of limitations, including high costs. Strategies based on new technologies need to be developed and tested to improve the detection of cervical cancer at an early

Introduction: Leydig cell tumors (LCT) are the most common hormone-secreting testicular tumors; it is a rare cause for precocious pseudo-puberty in boys. The tumors secrete high amounts of testosterone. We present two cases of LCT in prepubertal boys presenting with precocious puberty. Case Reports: Case 1. A 6-year-old boy was referred from the pediatric department with a diagnosis of precocious puberty. The patient had reported enlarged and painless swelling of the left testicle from a year ago. The puberty status of the patient was A1P3G4. Ultrasonography examination had found left testicular mass. Elective radical orchiectomy of the left testicle was performed. Histopathological analysis confirmed the diagnosis of benign LCT. Case 2. A 6-year-old boy presented with an enlarged left testicle for the last three months. Features of puberty were noted on the patient (appearance of pubic and facial hair). The puberty status of the patient was A1P3G3. Left testicle US had found homogenous, hypoechoic mass with calcification. Bone age had found increased bone maturation. Increased androgen hormones were detected through a blood test. Radical orchiectomy of the left testicle was performed. The histopathological examination showed malignant LCT. Conclusion: Leydig cell tumors uncommonly occur in children. Prepubertal-aged boys presented with asymmetrical, firm, painless testicular enlargement with signs of puberty should be evaluated for LCT. Histopathological analysis is the mainstay of diagnosis and radical orchiectomy is the treatment of choice of LCT.