Background: Ovarian tumors in the girl child are sometimes revealed by the development of secondary sexual characteristics. The authors report the case of a five-year-old girl in whom the disease was revealed by early...Background: Ovarian tumors in the girl child are sometimes revealed by the development of secondary sexual characteristics. The authors report the case of a five-year-old girl in whom the disease was revealed by early puberty. Case presentation: A five-year-old girl with an enlarged abdomen for about four months. The onset of pain and the sensation of a mass prompted the consultation. The development of secondary sexual characteristics (SSC) noted by the family had not been mentioned. The patient was classified as pubertal stage 2 according to the Tanner classification. An abdominal ultrasound and a CT scan showed a large left ovarian mass, an enlarged uterus for the patient’s age and a normal right ovary. The hormonal workup was not contributive. The treatment consisted only of a left salpingo-ovarectomy, without complementary chemotherapy. Anatomic pathological examination of the surgical specimen concluded to a juvenile tumor of the granulosa. The evolution was good with a beginning of regression of the HSC one month after the ovarectomy. Discussion: Granulosa tumors are sometimes secretory cancers, generally with a low potential for malignancy and therefore a very good prognosis. Surgery based on total adnexectomy is the first-line treatment. The large size of the tumor, the presence of ascites and capsular rupture are factors of poor prognosis, hence the importance of early diagnosis. Conclusion: Routine comprehensive physical examination should be de rigueur for abdominal masses in girls, especially in the context of various beliefs that may impede early referral to care.展开更多
Introduction: Early puberty is defined by development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. In the West, one in five children out of 100,000 is concerned. Little i...Introduction: Early puberty is defined by development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. In the West, one in five children out of 100,000 is concerned. Little information on sub-Saharan African patients exists concerning this pathology. Objective: To determine the etiology and clinical characteristics of early puberty in a cohort of Ivorian children. Methods: We conducted a cross-sectional study between 2015 and 2017 in children admitted to early puberty in the unique Endocrinology Service of the country. The epidemiology and clinical characteristics were assessed. Results: The eight patients involved were all females. Their mean age at diagnosis was 7 years and 3 months and the mean age of first symptoms begun at 5 years and 6 months. Seven patients had a central precocious puberty (CPP) including five cases of idiopathic CPP (ICPP) treated by (GnRH agonist) and two cases with secondary precocious puberty (SPP). One of them has a hypothalamic hamartoma and the other a sequelae of encephalopathy. The last case had a peripheral precocious puberty (PPP) causes by ovarian dystrophy. Conclusion: Our results confirm the predominance of idiopathic central precocious puberty particularly in girls.展开更多
文摘Background: Ovarian tumors in the girl child are sometimes revealed by the development of secondary sexual characteristics. The authors report the case of a five-year-old girl in whom the disease was revealed by early puberty. Case presentation: A five-year-old girl with an enlarged abdomen for about four months. The onset of pain and the sensation of a mass prompted the consultation. The development of secondary sexual characteristics (SSC) noted by the family had not been mentioned. The patient was classified as pubertal stage 2 according to the Tanner classification. An abdominal ultrasound and a CT scan showed a large left ovarian mass, an enlarged uterus for the patient’s age and a normal right ovary. The hormonal workup was not contributive. The treatment consisted only of a left salpingo-ovarectomy, without complementary chemotherapy. Anatomic pathological examination of the surgical specimen concluded to a juvenile tumor of the granulosa. The evolution was good with a beginning of regression of the HSC one month after the ovarectomy. Discussion: Granulosa tumors are sometimes secretory cancers, generally with a low potential for malignancy and therefore a very good prognosis. Surgery based on total adnexectomy is the first-line treatment. The large size of the tumor, the presence of ascites and capsular rupture are factors of poor prognosis, hence the importance of early diagnosis. Conclusion: Routine comprehensive physical examination should be de rigueur for abdominal masses in girls, especially in the context of various beliefs that may impede early referral to care.
文摘Introduction: Early puberty is defined by development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. In the West, one in five children out of 100,000 is concerned. Little information on sub-Saharan African patients exists concerning this pathology. Objective: To determine the etiology and clinical characteristics of early puberty in a cohort of Ivorian children. Methods: We conducted a cross-sectional study between 2015 and 2017 in children admitted to early puberty in the unique Endocrinology Service of the country. The epidemiology and clinical characteristics were assessed. Results: The eight patients involved were all females. Their mean age at diagnosis was 7 years and 3 months and the mean age of first symptoms begun at 5 years and 6 months. Seven patients had a central precocious puberty (CPP) including five cases of idiopathic CPP (ICPP) treated by (GnRH agonist) and two cases with secondary precocious puberty (SPP). One of them has a hypothalamic hamartoma and the other a sequelae of encephalopathy. The last case had a peripheral precocious puberty (PPP) causes by ovarian dystrophy. Conclusion: Our results confirm the predominance of idiopathic central precocious puberty particularly in girls.
