Aromatase Inhibitor, Anastrozole, Therapy for Precocious Puberty in 3-year-old Girl with the McCune-Albright Syndrome

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We present the case of a 3-year-old girl with McCune-Albright Syndrome (MAS). She was referred to our clinic for mammary gland enlargement and vaginal bleeding. A right ovarian cyst was detected by abdominal MRI and pelvic ultrasound examination, and it was followed up as a functional cyst. Endocrine studies showed gonadotropin-independent precocious puberty. A bone scintigram, revealed polyostotic fibrous dysplasia. These data confirmed the diagnosis of MAS without skin pigmentation (café-au-lait spot). We treated the patient with the aromatase inhibitor, anastrozole (Arimidex^R), because of repeated vaginal bleedings. After 6 mo of treatment, the frequency of vaginal bleeding was clearly decreased and the level of estradiol was down to within normal limits. The aromatase inhibitor, anastrozole, appears to be an effective treatment for precocious puberty caused by MAS.