title: Gonadotropin-dependent precocious puberty: neoplastic causes and endocrine considerations.
abstract: Premature activation of the hypothalamic-pituitary-gonadal (HPG) axis manifests as gonadotropin-dependent precocious puberty. The mechanisms behind HPG activation are complex and a clear etiology for early activation is often not elucidated. Though collectively uncommon, the neoplastic and developmental causes of gonadotropin-dependent precocious puberty are very important to consider, as a delay in diagnosis may lead to adverse patient outcomes. The intent of the current paper is to review the neoplastic and developmental causes of gonadotropin-dependent precocious puberty. We discuss the common CNS lesions and human chorionic gonadotropin-secreting tumors that cause sexual precocity, review the relationship between therapeutic radiation and gonadotropin-dependent precocious puberty, and finally, provide an overview of the therapies available for height preservation in this unique patient population.
authors: Department of Pediatrics, The University of Texas Health Science Center, Houston, TX 77030, USA.
authors: Matthew D
authors: MD
authors: Stephen
authors: Peter E
authors: PE
authors: Zage
authors: Steven G
authors: SG
authors: Waguespack
references: N Engl J Med. 1989 Jul 20;321(3):143-51
references: 2501681
references: Arch Pediatr Adolesc Med. 1996 Jun;150(6):589-92
references: 8646307
references: J Clin Endocrinol Metab. 2004 Dec;89(12):6100-4
references: 15579765
references: J Neurosurg. 1994 Oct;81(4):601-4
references: 7931595
references: Pediatr Neurol. 2004 Feb;30(2):143-5
references: 14984911
references: Clin Endocrinol (Oxf). 2009 Oct;71(4):524-8
references: 19508611
references: Pediatrics. 2009 Jan;123(1):84-8
references: 19117864
references: N Engl J Med. 2003 Oct 23;349(17):1614-27
references: 14573733
references: Neurosurgery. 1994 Jun;34(6):949-58; discussion 958
references: 8084405
references: Am J Pathol. 1978 Jun;91(3):606
references: 350057
references: J Pediatr Endocrinol Metab. 2000 Jul;13 Suppl 1:703-8
references: 10969912
references: Pediatrics. 1984 Jul;74(1):97-102
references: 6739222
references: J Child Neurol. 2008 Oct;23(10):1136-48
references: 18952580
references: J Neurosurg. 1998 Oct;89(4):547-51
references: 9761047
references: Pediatrics. 1981 Feb;67(2):236-44
references: 7243449
references: J Clin Endocrinol Metab. 1999 Dec;84(12):4317-23
references: 10599681
references: Pediatrics. 2002 Jan;109(1):61-7
references: 11773542
references: J Pediatr Endocrinol Metab. 2006 Apr;19 Suppl 1:355-66
references: 16700311
references: J Pediatr Endocrinol Metab. 2006 Apr;19 Suppl 1:289-93
references: 16700303
references: Pediatrics. 2003 Jan;111(1):47-51
references: 12509553
references: AJNR Am J Neuroradiol. 1991 Mar-Apr;12(2):309-14
references: 1902033
references: N Engl J Med. 2008 May 29;358(22):2366-77
references: 18509122
references: J Clin Endocrinol Metab. 1994 Jun;78(6):1282-6
references: 8200926
references: Clin Endocrinol (Oxf). 2006 Aug;65(2):239-45
references: 16886967
references: JAMA. 1997 Jul 2;278(1):51-7
references: 9207339
references: J Biol Chem. 2001 Sep 14;276(37):34631-6
references: 11457843
references: J Clin Endocrinol Metab. 2003 Oct;88(10):4590-5
references: 14557427
references: Orphanet J Rare Dis. 2007 Apr 10;2:18
references: 17425791
references: J Med Assoc Thai. 2003 Jun;86 Suppl 2:S145-51
references: 12929982
references: Pediatrics. 2002 Jan;109(1):139-41
references: 11773552
references: J Endocrinol Invest. 2005 Nov;28(10):935-9
references: 16419497
references: J Clin Endocrinol Metab. 1994 Jan;78(1):30-5
references: 7507123
references: Pediatr Radiol. 1995;25(1):7-11
references: 7761174
references: Childs Nerv Syst. 2005 Aug;21(8-9):729-46
references: 16044343
references: Am J Med Genet A. 2006 Mar 1;140(5):471-81
references: 16470792
references: Arch Dis Child. 1969 Jun;44(235):291-303
references: 5785179
references: Neuropsychiatr Dis Treat. 2008 Dec;4(6):1021-31
references: 19337448
references: J Neurooncol. 1996 May-Jun;28(2-3):223-31
references: 8832464
references: J Neurosurg Pediatr. 2009 Aug;4(2):105-12
references: 19645541
references: J Pediatr. 1992 May;120(5):709-15
references: 1533661
references: J Pediatr Endocrinol Metab. 2000 Jul;13 Suppl 1:687-93
references: 10969910
references: Horm Res. 2001;56(1-2):12-8
references: 11815722
references: Cancer. 1987 Apr 1;59(7):1353-7
references: 3815306
references: Clin Pediatr (Phila). 2003 Mar;42(2):181-4
references: 12659393
references: Curr Opin Neurol. 2009 Feb;22(1):11-8
references: 19155759
references: Neurol India. 1999 Jun;47(2):148-51
references: 10402344
references: J Pediatr Endocrinol Metab. 2003 Mar;16(3):447-55
references: 12705372
references: J Pediatr Endocrinol Metab. 2005 Sep;18(9):849-52
references: 16279361
references: Horm Res. 2002;57 Suppl 2:2-14
references: 12065920
references: Endocr Dev. 2009;15:25-39
references: 19293602
references: J Neurosurg. 2005 Aug;103(2):224-32
references: 16175850
references: J Clin Endocrinol Metab. 1993 Jul;77(1):118-24
references: 8325933
references: J Pediatr Endocrinol Metab. 2000 Jul;13 Suppl 1:695-701
references: 10969911
references: Lancet Oncol. 2009 May;10(5):508-15
references: 19410195
references: J Clin Endocrinol Metab. 1999 Dec;84(12):4695-701
references: 10599738
references: Mutat Res. 2008 Sep-Oct;659(3):284-92
references: 18598780
references: Pediatr Neurosurg. 1999 Dec;31(6):316-21
references: 10702732
references: Pediatrics. 2002 Oct;110(4):752-7
references: 12359790
references: Lancet Oncol. 2007 Aug;8(8):685-95
references: 17644483
references: Clin Endocrinol (Oxf). 1995 Jun;42(6):641-6
references: 7634506
references: Childs Nerv Syst. 2009 Oct;25(10):1303-12
references: 19387655
references: J Pediatr (Rio J). 2007 Nov;83(5 Suppl):S172-7
references: 17901908
references: J Neurosurg. 2007 Jul;107(1 Suppl):66-8
references: 17644924
references: Eur J Pediatr. 1992 Jan;151(1):76
references: 1728553
references: Pediatrics. 2008 Feb;121 Suppl 3:S208-17
references: 18245513
references: Pediatrics. 1996 Apr;97(4):517-9
references: 8632938
references: J Med Genet. 1996 Jul;33(7):585-9
references: 8818945
references: Horm Res. 2002;57 Suppl 2:31-4
references: 12065923
references: J Child Neurol. 2007 Jun;22(6):775-9
references: 17641270
references: Acta Paediatr. 2001 Jul;90(7):751-6
references: 11519977
references: Best Pract Res Clin Endocrinol Metab. 2002 Mar;16(1):91-103
references: 11987901
references: AJNR Am J Neuroradiol. 2004 Aug;25(7):1283-5
references: 15313725
references: Int J Radiat Oncol Biol Phys. 2006 Aug 1;65(5):1440-5
references: 16863927
references: Horm Res. 2008;69(2):114-23
references: 18059092
references: Pediatrics. 2009 Jan;123(1):124-33
references: 19117870
references: Med Pediatr Oncol. 1998 Jun;30(6):351-6
references: 9589084
references: Childs Nerv Syst. 2009 Mar;25(3):281-4
references: 19153750
references: Pediatrics. 2008 Feb;121 Suppl 3:S172-91
references: 18245511
references: J Clin Endocrinol Metab. 2007 Apr;92(4):1424-9
references: 17284632
references: Brain. 1988 Dec;111 ( Pt 6):1355-81
references: 3145091
references: Turk Neurosurg. 2007 Jul;17(3):211-8
references: 17939110
references: Arch Dis Child. 1970 Feb;45(239):13-23
references: 5440182
references: J Pediatr Hematol Oncol. 1995 May;17(2):167-71
references: 7749768
references: Cancer. 2009 Jun 1;115(11):2562-70
references: 19309737
references: N Engl J Med. 2008 Feb 14;358(7):709-15
references: 18272894
references: J Clin Endocrinol Metab. 1995 Dec;80(12):3763-6
references: 8530631
references: Am J Med Genet. 1996 Oct 2;65(1):76-81
references: 8914745
references: Endocr Dev. 2005;8:81-93
references: 15722619
references: Pediatrics. 1997 Apr;99(4):505-12
references: 9093289
references: N Engl J Med. 1984 Oct 4;311(14):920
references: 6472407
references: Pediatrics. 2005 Dec;116(6):1323-8
references: 16322154
references: J Cancer Surviv. 2007 Dec;1(4):261-74
references: 18648961
references: J Cell Physiol. 2008 Dec;217(3):584-9
references: 18651562
references: Pediatrics. 1999 Oct;104(4 Pt 1):936-41
references: 10506238
references: Pediatr Endocrinol Rev. 2007 Sep;5(1):471-81
references: 17925788
references: Pediatr Neurosurg. 1998 Jan;28(1):49-55
references: 9693331
references: J Neurosurg. 2007 Jan;106(1 Suppl):3-12
references: 17233305
references: J Clin Endocrinol Metab. 1981 Sep;53(3):656-60
references: 7263846
references: Med Pediatr Oncol. 1997 Oct;29(4):280-7
references: 9251734
references: Q J Med. 1989 Feb;70(262):145-60
references: 2594955
references: Pediatrics. 2003 Jan;111(1):110-3
references: 12509562
references: Growth Horm IGF Res. 2004 Jun;14 Suppl A:S118-24
references: 15135792
references: Ann Oncol. 2002 Jun;13(6):975-7
references: 12123344
references: J Pediatr Endocrinol Metab. 2005 Sep;18(9):843-4
references: 16279359
references: Peptides. 2009 Jan;30(1):139-45
references: 18634841
references: Horm Res. 2009;72(2):114-9
references: 19690429
references: Nature. 2001 May 31;411(6837):613-7
references: 11385580
references: J Neurosurg. 1999 Aug;91(2):212-20
references: 10433309
references: J Med Genet. 1989 Nov;26(11):704-11
references: 2511318
references: Neurology. 2008 Feb 19;70(8):653-5
references: 18057317
references: Arq Bras Endocrinol Metabol. 2008 Feb;52(1):18-31
references: 18345393
references: Arch Dis Child. 1994 Feb;70(2):116-8
references: 8129431
references: J Pediatr Endocrinol Metab. 2006 Nov;19(11):1371
references: 17220068
references: Acta Paediatr Taiwan. 2001 Jul-Aug;42(4):243-7
references: 11550415
references: Pediatrics. 1999 Oct;104(4 Pt 2):1014-8
references: 10506254
references: J Pediatr. 2003 Oct;143(4):426-7
references: 14571212
references: J Pediatr Endocrinol Metab. 2002 Sep-Oct;15(8):1195-201
references: 12387519
references: Endocr Rev. 2009 Oct;30(6):713-43
references: 19770291
references: Clin Endocrinol (Oxf). 2001 Mar;54(3):287-8
references: 11298078
references: J Clin Endocrinol Metab. 2003 Oct;88(10):4731-9
references: 14557448
references: Pediatr Clin North Am. 2008 Feb;55(1):121-45, xi
references: 18242318
references: Epilepsia. 2005 Jan;46(1):42-7
references: 15660767
references: Cell Death Differ. 2007 May;14(5):895-906
references: 17096025
references: J Clin Endocrinol Metab. 2008 Mar;93(3):823-31
references: 18165285
references: J Clin Endocrinol Metab. 1993 Apr;76(4):851-6
references: 8473395
references: J Child Neurol. 2002 Aug;17(8):613-21; discussion 627-9, 646-51
references: 12403560
references: Endocr Relat Cancer. 2004 Dec;11(4):589-602
references: 15613441
references: J Pediatr. 1995 Jun;126(6):955-8
references: 7776106
references: Proc Natl Acad Sci U S A. 2003 Sep 16;100(19):10972-6
references: 12944565
references: Pediatrics. 2009 Apr;123(4):e752-62
references: 19332438
references: J Pediatr Endocrinol Metab. 2008 Dec;21(12):1113-8
references: 19189683
references: J Clin Endocrinol Metab. 1991 Apr;72(4):888-98
references: 2005216
references: Horm Res. 2004;62(4):168-76
references: 15331852
references: Childs Nerv Syst. 2005 Aug;21(8-9):747-57
references: 15995885
references: J Med Assoc Thai. 2000 Sep;83(9):1105-11
references: 11075980
references: Ann Neurol. 2007 Mar;61(3):189-98
references: 17387725
references: Indian Pediatr. 2007 Nov;44(11):858-60
references: 18057486
references: N Engl J Med. 1993 Jan 14;328(2):87-94
references: 8416438
references: Eur J Pediatr. 2008 May;167(5):583-5
references: 17541635
references: J Endocrinol Invest. 2000 Dec;23(11):721-3
references: 11194703
references: Pediatr Blood Cancer. 2008 Apr;50(4):854-8
references: 17729247
references: Pediatrics. 2002 Nov;110(5):911-9
references: 12415029
references: J Clin Endocrinol Metab. 2010 May;95(5):2276-80
references: 20237166
references: J Biol Chem. 2001 Aug 3;276(31):28969-75
references: 11387329
references: Horm Res. 2009 Jan;71 Suppl 1:64-7
references: 19153509