Precocious puberty is the onset of pubertal development at an earlier age than is expected based upon established normal standards. The cause of precocious puberty may range from a variant of normal development (eg. premature adrenarche or isolated premature thelarche) to pathologic conditions with significant risk of morbidity and even death (eg. malignant germ-cell tumor or astrocytoma). A case of an 18 month old female presenting with vaginal bleeding following a previously noted breast enlargement was described. Initial assessment based on the patient's history and physical examination is suggestive of precocious puberty. Hormonal studies indicated normal levels of FSH and LH, with an elevation in estradiol. Radiographic analysis showed a normal bone age. Cranial MRI revealed no abnormal masses. Sonographic evaluation showed bilateral cystic masses in the ovaries. A diagnosis of peripheral precocious puberty associated with functional ovarian cysts was made, and the patient was monitored for progression of pubertal development.

Human ; Female ; Infant ; Familial Testotoxicosis ; Puberty, Precocious ; Estradiol ; Adrenarche ; Ovarian Cysts ; Gigantomastia ; Breast ; Hypertrophy ; Astrocytoma ; Neoplasms, Germ Cell And Embryonal ; Uterine Hemorrhage

A 44‑year‑old woman presented with an abnormal vaginal discharge. She was initially diagnosed with cervical intraepithelial neoplasia‑1 through Papanicolaou smear and was managed with cryotherapy and completed human papillomavirus vaccinations. Nine years later, gynecologic examination showed a cervical mass, and biopsy revealed a signet‑ring cell‑type mucinous adenocarcinoma. Extensive systemic evaluation performed revealed no other malignancies. Radical hysterectomy was performed, and final pathology report showed a primary signet-ring cell cervical carcinoma stage 1B2. Concurrent chemotherapy with adjuvant external beam radiation therapy was then given. The patient has no evidence of disease for 24 months now since diagnosis. Primary signet‑ring cell carcinoma of the cervix is rare. It is diagnosed when no other tumor is found in extragenital sites, histology consists of signet‑ring morphology, tumor includes areas of adenocarcinoma in situ, and case has a prolonged survival. Overall patient education plays a vital role in management.
Papanicolaou Test ; Papillomavirus Infections ; Carcinoma, Signet Ring Cell ; Human Papillomavirus Viruses