Imaging findings in a male pediatric patient by central precocious puberty: A case report

TL;DR

A 5-year-old boy with early puberty signs was diagnosed with a pituitary microadenoma through imaging and clinical evaluation.

Contribution

This case report highlights the use of neuroimaging in diagnosing pituitary microadenoma as a cause of central precocious puberty in a male pediatric patient.

Findings

The patient exhibited secondary sexual development consistent with Tanner stage 5 at age 5.

MRI revealed a pituitary microadenoma as the underlying cause of central precocious puberty.

Skeletal maturation showed a bone age advanced to that of an 11-year-old.

Abstract

Precocious puberty (PP) refers to the early onset of secondary sexual characteristics, occurring before 8 years of age in females and 9 in males. This condition commonly results from a premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, a phenomenon identified as central precocious puberty (CPP). Central precocious puberty (CPP) in females is predominantly idiopathic, whereas in males, it is mostly caused by hypothalamic-pituitary lesions. Diagnosis is established through comprehensive clinical assessment, encompassing a thorough anamnesis from both the patient and their caregivers, detailed physical examination, and Tanner staging conducted by a pediatric endocrinologist. Neuroimaging, particularly brain MRI, is employed to detect intracranial anomalies or pituitary pathology, with pituitary microadenomas being a commonly observed finding. This report presents the case of a 5-year-old male who exhibited signs of secondary sexual development, with testicular volume consistent with Tanner stage 5 based on laboratory evaluation. Assessment of skeletal maturation revealed a significantly advanced bone age, approximating that of a 11-year-old child. The patient underwent an ultrasound examination by the results of testicular volume greater than the normal value of his age. Due to the results of the examination, the patient underwent an MRI examination of the head to find the cause by the conclusion on MRI, namely pituitary microadenoma.

Figures