Abstract
The main symptoms were mammary development and genital bleeding. Mammary development started at 7 months of age and bleeding occurred at 9 months of age.
Blood level of LH was 2.5mIU/ml, FSH<2mIU/ml and E2 57.6pg/ml. The LH·RH test response was poor and mass was not detected in USG. Between the initial examination and the first operation, the mammary gland enlargement was not marked, genital bleeding stationary and the bone age at 1 year and 10 months was equivalent to 2 years and 6 months. Stature was +1.0 SD to +3.0 SD, and E2 10-281pg/ml. Enlargement of the left ovary was seen in CT scan and USG.
At the time of the first operation at 4 years, a left ovarian cystectomy was performed. The histological diagnosis was a follicular cyst. E2 in the follicular fluid was 39, 800pg/ml.
Genital bleeding appeared after about 6 months, E2 was 157pg/ml, the LH. RH test response was poor and enlargement of the left ovary was seen in USG. The second operation was left ovarian cystectomy performed at 5 years. The diagnosis showed a lute inized follicular cyst. E2 in the follicular fluid was 98, 700pg/ml.
This case appeared to be ovarian precocious puberty, but true (idiopathic) precocious puberty could not be ruled out. We hope to observe the course of this patient over a long period in the future.
