Jordanian Girl with Juvenile Granulose Cell Tumor Presented as Precocious Puberty: A Case Report

F. F. Ayyash, Abdalrazzaq Ahmmad Alyassen, Samer Sukre Karadsheh, Ibrahim Mohammad Sawalha, Alia MusaAl-Khlaifat, Alaeddin Ali Saleh, Omar Ashokaibi, Mustafa Al-haji
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Abstract

Objective: Our objective is to explain precocious puberty, type, etiology, investigation, how to differentiate between central and peripheral precocious puberty, and focus on one of the rarest causes of precocious puberty. Case report: In our case of precocious puberty, a two-year-old female presented with bilateral breast enlargement, vaginal secretion, pubic hair, and abdominal swelling. An abdominal and pelvic CT shows a very large ovarian mass. Asalpino-oophorectomy was carried out with regression of symptoms and signs and improvement in laboratory exams. The biopsy showed Juvenile Granulosa Cell Tumors (JGCT). Discussion: Due to an increase in the levels of estradiol and no increase in the gonadotropins (LH, FSH), advanced bone age and height age are compatible with the chronic age of 2 years old, so we think about peripheral precocious puberty. Due to abdominal swelling and patient age (small age), we suspect malignancy, so we did a CT scan and sonography of the pelvis. Conclusion: Every patient with signs and symptoms of precocious puberty must do all the investigation that leads to diagnosis, especially when there is a red flag like in our patient (very small age).
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以性早熟为表现的约旦女孩少年颗粒细胞瘤1例报告
目的:我们的目的是解释性早熟,类型,病因,调查,如何区分中枢性和外周性早熟,并重点关注性早熟的一种罕见的原因。病例报告:在我们的性早熟病例中,一名两岁的女性表现为双侧乳房增大,阴道分泌物,阴毛和腹部肿胀。腹部及盆腔CT显示卵巢有一个很大的肿块。在症状和体征消退和实验室检查改善的情况下进行了卵巢切除术。活检显示幼年颗粒细胞瘤(JGCT)。讨论:由于雌二醇水平升高而促性腺激素(LH, FSH)未升高,骨龄和身高年龄超前与2岁的慢性年龄相适应,因此我们认为是外周性性早熟。由于腹部肿胀和患者年龄(小),我们怀疑是恶性肿瘤,因此我们对骨盆进行了CT扫描和超声检查。结论:每一个有性早熟体征和症状的患者都必须做所有的调查来诊断,特别是当有一个危险信号时,就像我们的病人(很小的年龄)。
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