title: Luteinizing hormone secreting adrenal tumour as a cause of precocious puberty.
abstract: A boy aged 6 years presented with genital precocity, enlarged testes and advanced linear growth. An ovoid mass 3-4 cm in diameter was identified by MRI scan in the right adrenal gland. Serum concentrations of LH, testosterone, alpha-subnuit, dehydroepiandrosterone sulphate, androstenedione and oestradiol were persistently elevated. LH was unresponsive to bolus i.v. injection of GnRH or to GnRH analogue therapy. Serum FSH was normal. After removal of the adrenal tumour, serum LH, alpha-subunit, testosterone and adrenal androgen levels fell to normal. In incubation medium of cultured disaggregated tumour cells, LH concentrations were greater than twice the mean serum concentration and 4-5-fold higher than in the medium of cultured non-neoplastic adrenal cells. Specific immunostaining of the tumour was positive for LH and alpha-subunit in many areas and these were not found in the adjacent non-neoplastic adrenal. Testicular biopsy showed almost complete spermatogenesis although germinal cell types were numerically lower than in normal men. These findings are consistent with an adrenocortical adenoma secreting LH being the cause of the patient's precocious puberty.
authors.affiliation: Child Health Centre, Warsaw, Poland.
authors.forename: T E
authors.initials: TE
authors.lastname: Romer
authors.forename: K
authors.initials: K
authors.lastname: Sachnowska
authors.forename: M O
authors.initials: MO
authors.lastname: Savage
authors.forename: B
authors.initials: B
authors.lastname: Woziewicz
authors.forename: D G
authors.initials: DG
authors.lastname: Lowe
authors.forename: K K
authors.initials: KK
authors.lastname: Kula
authors.forename: R
authors.initials: R
authors.lastname: Janas
authors.forename: L
authors.initials: L
authors.lastname: Malendowicz
authors.forename: G M
authors.initials: GM
authors.lastname: Besser
mesh_terms: D000236:Adenoma / Q000097:blood / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D000735:Androstenedione / Q000097:blood; D002648:Child; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D015292:Glycoprotein Hormones, alpha Subunit / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood / Q000378:metabolism*; D008297:Male; D011629:Puberty, Precocious / Q000097:blood / Q000209:etiology*; D013739:Testosterone / Q000097:blood
chemical_list: D015292:Glycoprotein Hormones, alpha Subunit; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone