title: Central precocious puberty and granulosa cell ovarian tumor in an 8-year old female.
abstract: Ovarian tumors associated with hormonal changes of the peripheral iso-sexual precocious puberty are of common presentation. We describe here a rare case of juvenile granulosa cell tumor in a female with central precocious puberty (CPP). An 8-year old girl with CPP presented with vaginal bleeding four months after the diagnosis and before starting treatment with gonadotropin-releasing hormone (GnRH)-analogs. Suppression of basal follicle-stimulating hormone (FSH) level, elevation of serum estradiol, progesterone and Cancer Antigen-125 were documented. Abdominal ultrasound examination (US) and magnetic resonance imaging showed a pelvic mass affecting the left ovary. A left salpingo-oophorectomy was performed and the mass was totally resected. Juvenile granulosa cell ovarian tumor was diagnosed. One month post surgery, estradiol and progesterone decreased to values of the first evaluation and FSH increased; Cancer Antigen-125 resulted normal while ultrasound pelvic examination showed absence of pelvic masses. In our patient, the tumor had grown very quickly since hormonal data demonstrated a CPP without any evidence of ovarian mass on US only four months before diagnosis. The overstimulation of the FSH or aberrant activation of FSH receptors may have contributed to the development of the mass.
authors.affiliation: Department of the Mother and Child Health, Pediatric Unit, IRCCS Policlinico San Matteo Foundation and Department of Internal Medicine, University of Pavia , Pavia, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Calcaterra
authors.forename: Ghassan
authors.initials: G
authors.lastname: Nakib
authors.forename: Gloria
authors.initials: G
authors.lastname: Pelizzo
authors.forename: Barbara
authors.initials: B
authors.lastname: Rundo
authors.forename: Gaetana
authors.initials: G
authors.lastname: Anna Rispoli
authors.forename: Stella
authors.initials: S
authors.lastname: Boghen
authors.forename: Federico
authors.initials: F
authors.lastname: Bonetti
authors.forename: Barbara
authors.initials: B
authors.lastname: Del Monte
authors.forename: Chiara
authors.initials: C
authors.lastname: Gertosio
authors.forename: Daniela
authors.initials: D
authors.lastname: Larizza
keywords: central precocious puberty; children; juvenile granulosa cell; ovarian tumor