ESPE Abstracts

Central precocious puberty is more common in girls than boys and over 90% of girls central precocious puberty is idiopathic Pathological causes of central precocious puberty in very young girls include tumors, hydrocephalus, CNS infections, or post-traumatic events Astrocytoma is one of the very rare causes. Pilocytic astrocytomas are usually benign and may be diagnosed before the onset of precocious puberty due to neurological symptoms or be diagnosed for the first time in children presenting for pubertal symptoms. We report a case of a 7-year-old girl admitted to the hospital with breast enlargement (Tanner B3-4), with vaginal discharge Five years ago, the patient had weakness in the left side of the body with brain MRI showing a large tumor in the pituitary fossa and right hemisphere. The medical team concluded that she had a juvenile pilocytic astrocytoma (JPA) tumor based on biopsy collected from the surgery. Following the surgery, the medical team continued to have MRI scans in the following 3 months and decided that she had to go through a chemotherapy (carboplastine & vincristine) for another 1 year due to the fact that the tumor exhibited pattern to grow back After the baby was treated for astrocytoma, she was quite stable and recovered well, & then she showed symptoms of precocious puberty. The cause-and-effect relationship between this tumor and her precocious puberty not much has been described in the literature. Current endocrine tests are qualified to diagnose central precocious puberty with LH: 4.63mUI/ml, FSH: 5.59mUI/ml, Estradiol: 48.8pg/ml, bone age is 9 years old The patient was treated with triptorelin 11.25 mg every 3 months. After 12 months of treatment, clinical and laboratory signs of precocious puberty were completely suppressed. Clinical presentation of stable neurologic deficit with left hemiparesis. To our knowledge, this is the first description in Vietnam of a case of central precocious puberty in a juvenile pilocytic astrocytoma that was previously treated with combined partial resection and chemotherapy. Among them, pilocytic astrocytoma is one of the very rare causes with a good prognosis. Timely detection and treatment can help prevent symptoms of precocious puberty. In this case, we found that the combination of partial tumor resection with chemotherapy has a relatively good prognosis, especially according to the literature most of these tumors are benign. Treatment of precocious puberty in this child with triptoreline was effective and did not increase the size of the tumor or other neurological symptoms.