SUMMARY Endocrine studies in girls with precocious thelarche were compared with those of normal girls of similar ages. Girls with precocious thelarche showed breast development and oestrogenised vaginal smears as the only signs of precocious sexual development. A few of the girls were tall and some had advanced bone ages but these two findings were not consistently present in the same patient. Hormones-such as serum oestradiol, oestrone, A 4-androstenedione, progesterone, dehydroepiandrosterone (DHEA), follicle-stimulating hormone, luteinising hormone, and prolactin, and urinary 17-ketosteroids-were measured. Only DHEA was different, being higher in girls with precocious thelarche. It is suggested that the high DHEA level may serve as a precursor for conversion to oestrogens in the target tissues, breast, and vagina. This mechanism for oestrogenisation has been reported in other patients.
Summary
Precocious puberty with signs of masculinization and elevation of choriogonadotrophic activity in a girl 7½ years old was found to be due to a hormonally active ovarian tumour. The tumour was composed of germ cells, Leydig cells, Sertoli granulosa‐like cells, trophoblastic and teratoid portions, and was therefore, termed a terato‐chorio‐gonadoblastoma. Hormonal data were correlated with the histological and ultrastructural findings. This unusual tumour caused precocious puberty coupled with virilization and high choriogonadotrophic activity in a girl 7½ years old.
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