Male patients presenting with rapidly progressive puberty associated with malignant tumors.
10.6065/apem.2016.21.1.51
- Author:
Soo Jung KIM
1
;
A Ra KO
;
Mo Kyung JUNG
;
Ki Eun KIM
;
Hyun Wook CHAE
;
Duk Hee KIM
;
Ho Seong KIM
;
Ah Reum KWON
Author Information
1. Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea. armea@yuhs.ac
- Publication Type:Case Report
- Keywords:
Puberty;
Neoplasms;
Germ-cell tumor
- MeSH:
Adolescent;
Child;
Chorionic Gonadotropin;
Diplopia;
Fever;
Humans;
Luteinizing Hormone;
Male*;
Mass Screening;
Physical Examination;
Polydipsia;
Polyuria;
Puberty*;
Puberty, Precocious;
Radiography;
Testis;
Testosterone;
Thorax;
Tumor Markers, Biological;
Weight Loss
- From:Annals of Pediatric Endocrinology & Metabolism
2016;21(1):51-55
- CountryRepublic of Korea
- Language:English
-
Abstract:
In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm.
