ESPE Abstracts (2014) 82 P-D-3-1-935

An Unusual Case of Early and Accelerated Puberty

Perla Scalini, Stefano Stagi, Paola Pelosi, Franco Ricci, Giulia Anzillotti, Paolo Del Greco, Salvatore Seminara & Maurizio de Martino

Health Science Department, Anna Meyer Children’s University Hospital, University of Florence, Florence, Italy

Background: Unlike precocious puberty, early and/or fast puberty have been less studied, despite the fact that this disorder may be associated to an organic lesion at CNS level.

Objective and hypotheses: We illustrate a case of early and fast puberty in a girl with an occult intra-cranial tumor.

Method: The girl was the first child of non-consanguineous, Italian parents. The family had a positive history of early puberty. Target height was 0.1 SDS. Pregnancy and neonatal period passed uneventfully. The proposita grew on the 10th centile during infancy and childhood. At the age of 8 years 11 months, she showed the first signs of an early puberty (height 125.5 cm, −1.17 SDS), but at 9.6 years old her height was 136 cm (0.01 SDS), BMI was 15.14 (−1.20 SDS), pubertal staging was B3–4PH3AH2. The height velocity was very high (16.01 SDS). So, she was referred to our unit.

Results: Neurological and ophthalmologic examinations were normal, such as biochemical and metabolic examinations. Thyroid and adrenal hormones were in the normal range. The LHRH test highlighted a very high LH (82.4 IU/l) and FSH peaks (29.6 IU/l). The α-fetoprotein, βHCG, and CEA were in the normal range. Pelvic ultrasonography showed a transitional uterus and enlarged ovaries with a normal echostructure. Bone age corresponded to the chronological age. The nuclear magnetic resonance imaging of the brain showed an impaired signal zone, 1 cm diameter with a rounded aspect, at a level of the left cerebral peduncle. The position of the tumor did not consent surgical therapy and biopsy of the mass; therefore, the patient began chemotherapy and radiotherapy.

Conclusion: Our case report confirms that LH and FSH values and also an accelerated development of puberty may be important in hypothesizing the presence of an endocranic tumor.

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