Coincidental Central Precocious Puberty and Wilms Tumor in a 5-Year-Old Girl

Table 1

Patient’s evolution.

	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

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.