A case of late presentation of precocious puberty due to pituitary astrocytoma

1 Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
2 Hazrat Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
3 Iran University of Medical Sciences, Tehran, Iran
4 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
Correspondence: Hazrat Rasoul-e-Akram Hospital, Niayesh Ave., Sattar-Khan St., 1445613131 Tehran, Iran, tel./fax: +98216651500/+982166509283; Fatemeh Jesmi, MD – fatemehjesmi@yahoo.com

Aktualn Neurol 2015, 15 (2), p. 91–95
DOI: 10.15557/AN.2015.0013
ABSTRACT

The importance of assessing precocious puberty, especially in boys, is not only due to the great complications it has for the affected patients, but also to the fatal underlying diseases. Therefore, children with central precocious puberty should first undergo neuroimaging. In this case study, we present a 9.5-year-old boy who was referred to Rasoul-e-Akram Medical Center with increased intracranial pressure, nausea/vomiting, and severe headache having begun three months earlier. The development of secondary sexual changes had started two years earlier, and had been neglected. His testes, penis, and pubic hair were at the fourth Tanner stage. He had elevated luteinizing and follicle stimulating hormones. Microscopic evaluation confirmed low-grade pilocytic astrocytoma WHO grade 1. Emergency brain surgery was conducted in which the brain was decompressed, and chemotherapy was started postoperatively. Two years after the surgery, he remains under chemotherapy, with obvious sexual maturation and a height of 154 cm. Training families and medical staff efficiently can help prevent the late diagnosis and treatment of precocious puberty and, as a result, help patients in their social life.

Keywords: puberty, precocious, central