Sexual precocity and recurrent beta-human chorionic gonadotropin upsurges preceding the diagnosis of a malignant mediastinal germ-cell tumor in a 9-year-old boy.
Numerous disorders are known to cause sexual precocity. Beta-human chorionic gonadotropin (beta-HCG)-secreting germ-cell tumors are one of the sources that have to be considered in the differential diagnosis of processes inducing a peripheral precocious puberty. Germ-cell tumors might be located in the ovaries or testes, retroperitoneum, mediastinum or the cranium. We present the case of a 9-year-old boy with sexual precocity and a recurrent transient beta-HCG elevation. After an interval of 2 years with repeated radiological examinations including the mediastinum, a mediastinal tumor was identified by magnetic resonance imaging. To our knowledge, this is the first case of a diagnosis of a mediastinal choriocarcinoma with a recurrent serum beta-HCG elevation. So far, factors that might be responsible for the repeated spontaneous beta-HCG decline are unknown.
Department of Pediatric Hematology and Oncology, Children's Hospital, Heinrich-Heine-University, Düsseldorf, Germany.
J
J
Schwabe
G
G
Calaminus
W
W
Vorhoff
V
V
Engelbrecht
B P
BP
Hauffa
U
U
Göbel
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001774:Blood Chemical Analysis; D002648:Child; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D018237:Germinoma / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D011629:Puberty, Precocious / Q000175:diagnosis*; D018570:Risk Assessment; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D018997:Chorionic Gonadotropin, beta Subunit, Human