title: Juvenile granulosa and theca cell tumor of the ovary as a rare cause of precocious puberty: case report and review of literature.
abstract: BACKGROUND
  The differential diagnosis for precocious puberty in a young female includes peripheral causes. This case documents a rare cause of peripheral precocious puberty--a juvenile granulosa and theca cell ovarian tumor--and a brief review of the literature for this tumor type.
  
  
  METHODS
  A 7-year-old girl presented with rapid onset of pubertal development and elevated estradiol levels. Menarche occurred 5 months after thelarche. A thorough workup revealed a large multicystic left ovary. Other causes of precocious puberty were excluded. She underwent an exploratory laparotomy and left salpingo-oophorectomy. Pathology reported a juvenile granulosa and theca cell tumor of the ovary, FIGO stage 1A. Postoperatively, she experienced a cessation of vaginal bleeding and estradiol levels normalized. A literature review found that early stage disease has an excellent prognosis and that adjuvant chemotherapy is not indicated in this setting.
  
  
  CONCLUSIONS
  Juvenile granulosa and theca cell tumor of the ovary is a rare cause of peripheral precocious puberty, even more so than juvenile granulosa cell tumor, due to the theca component. Treatment is surgical and an excellent prognosis is possible for early stage disease.
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Nathalie A
authors.initials: NA
authors.lastname: Fleming
authors.forename: Joseph
authors.initials: J
authors.lastname: de Nanassy
authors.forename: Sarah
authors.initials: S
authors.lastname: Lawrence
authors.forename: Amanda Y
authors.initials: AY
authors.lastname: Black
mesh_terms: D002648:Child; D005260:Female; D006106:Granulosa Cell Tumor / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D010051:Ovarian Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D011629:Puberty, Precocious / Q000209:etiology*; D013798:Thecoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography