Precocious pseudopuberty due to an autonomous ovarian follicular cyst: case report with a review of literaturesReport as inadecuate




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BMC Research Notes

, 6:319

First Online: 12 August 2013Received: 21 January 2013Accepted: 30 July 2013DOI: 10.1186-1756-0500-6-319

Cite this article as: Chae, H.S. & Rheu, C.H. BMC Res Notes 2013 6: 319. doi:10.1186-1756-0500-6-319

Abstract

BackgroundSmall follicular cysts are commonly found in the ovaries of prepubertal girls, and in most cases, they are of no clinical importance. These cysts are usually self-limiting and resolve spontaneously. However, occasionally, these cysts may enlarge and continue to produce estrogen, resulting in signs of sexual precocity. Here, we report a case of precocious pseudopuberty associated with an autonomous ovarian follicular cyst.

Case presentationA 5.9-year-old girl initially presented to a local clinic with vaginal bleeding and a large unilateral ovarian cyst. At 6 months after the initial acute episode, the patient visited our hospital as the ovarian cyst had persisted and increased in size. Endocrinological examination showed elevated estrogen levels and suppressed gonadotropin levels on GnRH stimulation test. Also, no skin pigmentation or bone anomaly was noted. Based on these observations, laparoscopic cystectomy was performed, and histologic analysis confirmed the diagnosis of a follicular cyst. After the laparoscopic cystectomy, the patient’s hormone levels returned to normal and no ovarian cyst was detected by ultrasound.

ConclusionsAs autonomous ovarian cysts are usually self-limiting disorder, no treatment is necessary. Therefore, surgical management should be deferred as long as possible to avoid the risk of repeat surgery, as pseudoprecocious puberty due to autonomous ovarian cysts can resolve spontaneoulsy and frequently recurs. Precocious pseudopuberty with an ovarian cyst may be due to granulosa cell tumor or may be one symptom of the McCune-Albright Syndrome MAS. A careful longer-term follow up of patients with autonomous ovarian cysts and-or molecular studies may be necessary in such cases.

KeywordsPrecocious pseudopuberty Autonomous ovarian follicular cyst Laparoscopic AbbreviationsGnRH stimulation testGonadotropin releasing hormone stimulation test

MASMcCune-Albright syndrome

GNASGuanine nucleotide binding, alpha stimulating complex.

Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-6-319 contains supplementary material, which is available to authorized users.

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Author: Hee Suk Chae - Chul Hee Rheu

Source: https://link.springer.com/







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