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As far as this boy's normal development has not been completed yet (Tanner 3 stage), I would say that this is a normal variation (puberty is a period of cataclysmic hormonal changes and alternations) and I would suggest no further investigation at this point (choice C).

A diagnostic challenge here might have been Klinefelter syndrome, but this would demand karyotyping, which is not an available option.

I actually had a similar case during my military service as a corps physician and referred the boy (he was actually 18yo) to an endocrinologist, who did not show empathy to my inquietude... :eek:
 
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