Central precocious puberty secondary to peripheral precocious puberty due to a pineal germ cell tumor: a case and review of literature.

Abstract

BACKGROUND:

The pineal lesion affecting melatonin is a rare cause of central precocious puberty by decreasing the inhibition of hypothalamic-pituitary-gonadal axis. Germ cell tumor secreting human chorionic gonadotropin is a rare cause of peripheral puberty.

CASE PRESENTATION:

A 5.8-year-old male presented facial hair and phallic growth, deepened voice, and accelerated growth velocity for 6 months. The elevated human chorionic gonadotropin level with undetectable gonadotropin levels indicated peripheral precocious puberty. Brain imaging revealed a pineal mass and further pathology indicated the diagnosis of teratoma. During chemoradiotherapy with operation, the elevated human chorionic gonadotropin level reduced to normal range, while the levels of gonadotropins and testosterone increased. Subsequently, progressing precocious puberty was arrested with gonadotrophin-releasing hormone analog therapy. Previous cases of transition from peripheral precocious puberty to central precocious puberty were reviewed. The transitions were caused by the suddenly reduced feedback inhibition of sex steroid hormones on gonadotropin releasing hormone and gonadotropins.

CONCLUSIONS:

For patients with human chorionic gonadotropin-secreting tumors, gonadotropin levels increase prior to sex steroid decrease, seems a sign of melatonin-related central PP related to melatonin.

• Authors: Han Chen, Cai-Yan Mo, Li-Yong Zhong
• Journal: BMC endocrine disorders (BMC Endocr Disord) Vol. 23 Issue 1 Pg. 237 (Oct 26 2023) ISSN: 1472-6823 [Electronic] England
• PMID: 37884982 (Publication Type: Review, Case Reports, Journal Article)
• Copyright: © 2023. The Author(s).

Chemical References

• Chorionic Gonadotropin
• Gonadal Steroid Hormones
• Gonadotropin-Releasing Hormone
• Melatonin

Topics

• Child, Preschool
• Humans
• Male
• Chorionic Gonadotropin
• Gonadal Steroid Hormones
• Gonadotropin-Releasing Hormone
• Melatonin (adverse effects)
• Neoplasms, Germ Cell and Embryonal (complications)
• Puberty, Precocious (etiology, pathology)