ESPE Abstracts

Eight years old girl presented with vaginal bleeding at Endocrine clinic. Bleeding occurred twice with 3 months apart. By examination: Height: 140 cm (2.3 SDS), Target height: (-0.6 SDS), Tanner staging: A1, P2, B3 bilaterally. Routine basic investigations were normal apart from microcytic hypochromic anemia. Thyroid profile was normal. Bone age was advanced (11 years), Abdominopelvic ultrasound showed normal average sized uterus with enlarged left ovary (15 ml) with 2 hemorrhagic cysts. Gonadotropin releasing hormone (GNRH) stimulation test was done. Luteinizing hormone (LH), Follicle stimulating hormone (FSH) post stimulation were (2.25,10.6mIU/ml respectively). Estradiol level was 80.42 pg/ml. She started to complain of chronic persistent headache, diplopia, blurring of vision, bony pain. MRI Pituitary Sella Turcica showed bulky pituitary gland with no micro or macro adenoma. But surprisingly it showed central skull base expansile ground glass osseous lesions involving sphenoidal body, sellar floor. Features impressive of skull base fibrous dysplasia. So, diagnosis of McCune-Albright syndrome was established. After multidisciplinary team consultation including (Endocrinologists, Neurosurgeons, Orthopedic surgeons, Ophthalmologists), she started medical treatment in the form of Aromatase inhibitors, Bisphosphonates, calcium and vitamin D. Continuous follow up of her hormonal profile, bone age every 6 months.