期刊论文详细信息
BMC Research Notes
Precocious pseudopuberty due to an autonomous ovarian follicular cyst: case report with a review of literatures
Chul Hee Rheu1  Hee Suk Chae1 
[1] Department of Obstetrics and Gynecology, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, South Korea
关键词: Laparoscopic;    Autonomous ovarian follicular cyst;    Precocious pseudopuberty;   
Others  :  1141892
DOI  :  10.1186/1756-0500-6-319
 received in 2013-01-21, accepted in 2013-07-30,  发布年份 2013
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【 摘 要 】

Background

Small 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 presentation

A 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.

Conclusions

As 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.

【 授权许可】

   
2013 Chae and Rheu; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Lee PA: Puberty and its disorders. In Lifshitz F ed. Pediatric Endocrinology. New York: Marcel Dekker; 2003:216-217.
  • [2]Millar DM, Blake JM, Stringer DA, Hara H, Babiak C: Prepubertal ovarian cyst formation: 5 years’ experience. Obstet Gynecol 1993, 81:434-438.
  • [3]de Sousa G, Wunsch R, Andler W: Precocious pseudopuberty due to autonomous ovarian cysts: a report of ten cases and long-term follow-up. Hormones (Athens) 2008, 7:170-174.
  • [4]Lyon AJ, De Bruyn R, Grant DB: Transient sexual precocity and ovarian cysts. Arch Dis Child 1985, 60:819-822.
  • [5]Qublan HS, Abdel-hadi J: Simple ovarian cysts: frequency and outcome in girls aged 2–9 years. Clin Exp Obstet Gynecol 2000, 27:51-53.
  • [6]Brandt ML, Helmrath MA: Ovarian cysts in infants and children. Semi Pediatr Surg 2005, 14:78-85.
  • [7]Lee PA: Laboratoy monitoring of children with precocious puberty. Arch Pediatr Adolesc Med 1994, 148:369-376.
  • [8]Oerter KE, Uriarte MM, Rose SR, Barnes KM, Cutler GB Jr: Gonadotropin secretory dynamics during puberty in normal girls and boys. J Clin Endocrinol Metab 1990, 71:1251-1258.
  • [9]Fakhry J, Khoury A, Kotval PS, Noto RA: Sonography of autonomous follicular ovarian cysts in precocious pseudopuberty. J Ultrasound Med 1988, 7:597-603.
  • [10]Fritz MA, Speroff L: Normal and abnormal growth and pubertal development. 8th edition. Philadelphia (PA): Lippincott, Williams & Wilkins; 2011:391-434.
  • [11]Sinnecker G, Willig RP, Stahnke N, Braendle W: Precocious pseudopuberty associated with multiple ovarian follicular cysts and low plasma estradiol concentrations. Eur J Pediatr 1999, 148:600-602.
  • [12]Brauner R, Bashamboo A, Rouget S, Goulet M, Philibert P, et al.: Clinical, biological and genetic analysis of prepubertal isolated ovarian cyst in 11 girls. PLoS One 2010, 5:e11282.
  • [13]Rodriguez-Macias KA, Thibaud E, Houang M, Duflos C, Beldjord C, Rappaport R: Follow up of precocious pseudopuberty associated with isolated ovarian follicular cysts. Arch Dis Child 1999, 81:53-56.
  • [14]Engiz O, Berberoglu M, Siklar Z, Bilir P, Ocal G: Treatment of autonomous ovarian follicular cyst with long-term anastrozole therapy. Indian J Pediatr 2009, 76:950-951.
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