Case Report
Coincidental Central Precocious Puberty and Wilms Tumor in a 5-Year-Old Girl
| | At admission | 4 months later | 10 months later |
| Clinical data | Weight 21 kg Height 117 cm Tanner stage II-breast development | Weight 21 kg Height 120 cm (+3 cm/4 months) Tanner stage III-breast development | Tanner stage II-breast development |
| Hormonal data | LH < 0.3 IU/L (normal range <0.5) FSH 0.9 IU/L (normal range <1) Estradiol < 20 ng/L (normal range <25) | LH 1.4 IU/L FSH 3.8 IU/L Estradiol 54 ng/L hCG < 2 U/L (normal range <2) LH (40 min post 100 µg triptorelin injection, sc) 13 IU/L FSH (40 min after 100 µg triptorelin injection, sc) 6.3 IU/L | LH 3.4 IU/L |
| Radiological data | Abdominal US well-circumscribed heterogeneous echogenic mass of 9.2 × 9.5 cm in right renal fossa | Bone age—8 years Pelvic US—normal ovary size and morphology, enlarged uterus with maximum length of 45 mm | | Brain MRI—Pituitary height of 6 mm and marked convexity of the upper surface. No lesions in the pineal or hypothalamic-optic region |
| Oncological diagnosis and treatment | Wilms tumor (nephroblastoma) | End chemotherapy | | SIOP WT01 protocol | Right nephrectomy |
| Endocrine diagnosis and treatment | PT No treatment | CPP GnRHa 11.25 mg intramuscularly every 3 months | Same treatment |
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LH: luteinizing hormone; FSH: follicular stimulating hormone; sc: subcutaneous; US: ultrasound; hCG: human chorionic gonadotropin; SIOP: International Society of Pediatric Oncology; PT: premature telarche; CPP: central precocious puberty; GnRHa: gonadotrophin releasing hormone analog.
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