ESPE Abstracts

Background: Previous studies have speculated that melatonin secreted by the pineal gland plays a role in the regulation of puberty, and pineal cyst may affect its secretory function, thus causing early pubertal development. However, there are few studies on early pubertal development with pineal cyst and its clinical features are not clear. This study aims to explore its clinical features and the relationship with cyst size to further improve the understanding of this disease.

Methods: The clinical, laboratory and imaging findings of children with early pubertal development complicated with pineal cyst admitted to the Children’s Hospital Affiliated to Zhengzhou University from January 2017 to February 2023 were retrospectively analyzed. According to the size of cysts, girls were divided into three groups(< 6mm, 6-10mm, >10mm), the difference in clinical characteristics was compared to explore the relationship between the size of pineal cysts and the development process of puberty.

Results: From January 2017 to February 2023, the incidence of pineal cyst in children with early pubertal development who underwent MRI examination of pituitary gland was 6.30% (478/7582), and the incidence of pineal cyst in children aged 7-9 years was the highest (348/478,72.80%). Among them, 213 children who met the screening criteria and had complete clinical data were included in the study. There were 203 girls (203/213,95.31%) and 10 boys (10/213,4.69%), which were consistent with the gender characteristics of early pubertal development. The height is higher than the average level of children of the same age, the bone age is mostly advanced, and the BMI is overweight or obese, which is in line with the clinical characteristics of early pubertal development. All children had no symptoms of cyst occupying. However, the proportion of rapidly progressing puberty, sex hormone levels and gonad size were further increased with the increase of cysts, with statistical significance (P < 0.05 for all). It is suggested that pineal cyst is closely related to precocious puberty, especially rapid progression precocious puberty.

Conclusion: The pineal cyst may promote the process of puberty development, leading to early pubertal development in patients. The most common age of visit was 7-9 years, and the cyst size was associated with the progression of puberty. It is a kind of central nervous system disease which can not be ignored in secondary central precocious puberty. Therefore, routine MRI examination of pituitary gland is recommended for all children with rapidly progressing puberty.