PRECOCIOUS PUBERTY DUE TO OVARIAN CYST – CASE REPORT
Keywords:Ovarian cyst, precocious puberty, precocious pseudopuberty, uterine hemorrhage, GnRh analog
Introduction: Ovarian cysts are rare in prepubertal girls. Autonomous ovarian cysts represent 5% of cases and can cause isosexual precocious pseudopuberty.
Case Report: A five years old girl was observed because of vaginal bleeding. Personal and family history was unremarkable. Physical examination confi rmed uterine haemorrhage and bilateral breast development. Pelvic ultrasound examination demonstrated a 30mm right ovarian cyst. Laboratory fi ndings, including thyroid function, were normal, excepting elevated oestrogen levels. GnRH stimulation test showed prepubertal response. There was no advanced bone age nor accelerated height velocity. She was regularly monitored at paediatric endocrinology consultation, without recurrent menorrhagia, there was regression of thelarche, associated with involution of the ovarian cyst.
Discussion/Conclusion: Most autonomous ovarian cysts regress spontaneously with regression of pubertal signs, as in the present case. Therapy with a GnRH agonist may become necessary in the case of transformation from precocious pseudopuberty to central precocious puberty after recurrences of the ovarian cysts or when there is significant loss of height potential.
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