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Male patients presenting with rapidly progressive puberty associated with malignant tumors.

Kim SJ, Ko AR, Jung MK, Kim KE, Chae HW, Kim DH, Kim HS, Kwon AR - Ann Pediatr Endocrinol Metab (2016)

Bottom Line: PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP.Histopathologic analysis confirmed a yolk-sac tumor.Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm.

No MeSH data available.


Related in: MedlinePlus

(A) Brain magnetic resonance imaging revealing mass lesions at pineal gland and suprasellar area. (B) Left hand bone age radiograph at diagnosis. The arrow indicates pineal gland and suprasellar area masses.
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Figure 2: (A) Brain magnetic resonance imaging revealing mass lesions at pineal gland and suprasellar area. (B) Left hand bone age radiograph at diagnosis. The arrow indicates pineal gland and suprasellar area masses.

Mentions: A 12.2-year-old boy presented with diplopia, polyuria, and polydipsia for 4 months and was referred to our hospital for further evaluation. He was diagnosed with a pineal-gland mixed GCTs without metastasis (Fig. 2). After surgical removal of the tumor, he was referred to our pediatric endocrinology clinic for pituitary hormone replacement. His past and family medical histories were unremarkable except for his pineal-gland mixed GCTs with elevated AFP (35.7 ng/mL; normal range, 0.6–3.9 ng/mL) and serum β-hCG (2,642 mIU/mL; normal range, <25 mIU/mL). On physical examination, the patient's height and weight placed him in the 50th–75th (155 cm) and 90th percentiles (57 kg), respectively. He was noted to have an advanced Tanner pubertal stage of P3 with testicular volumes of 8-mL for both testicles.


Male patients presenting with rapidly progressive puberty associated with malignant tumors.

Kim SJ, Ko AR, Jung MK, Kim KE, Chae HW, Kim DH, Kim HS, Kwon AR - Ann Pediatr Endocrinol Metab (2016)

(A) Brain magnetic resonance imaging revealing mass lesions at pineal gland and suprasellar area. (B) Left hand bone age radiograph at diagnosis. The arrow indicates pineal gland and suprasellar area masses.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835563&req=5

Figure 2: (A) Brain magnetic resonance imaging revealing mass lesions at pineal gland and suprasellar area. (B) Left hand bone age radiograph at diagnosis. The arrow indicates pineal gland and suprasellar area masses.
Mentions: A 12.2-year-old boy presented with diplopia, polyuria, and polydipsia for 4 months and was referred to our hospital for further evaluation. He was diagnosed with a pineal-gland mixed GCTs without metastasis (Fig. 2). After surgical removal of the tumor, he was referred to our pediatric endocrinology clinic for pituitary hormone replacement. His past and family medical histories were unremarkable except for his pineal-gland mixed GCTs with elevated AFP (35.7 ng/mL; normal range, 0.6–3.9 ng/mL) and serum β-hCG (2,642 mIU/mL; normal range, <25 mIU/mL). On physical examination, the patient's height and weight placed him in the 50th–75th (155 cm) and 90th percentiles (57 kg), respectively. He was noted to have an advanced Tanner pubertal stage of P3 with testicular volumes of 8-mL for both testicles.

Bottom Line: PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP.Histopathologic analysis confirmed a yolk-sac tumor.Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm.

No MeSH data available.


Related in: MedlinePlus