Etiology of Central Precocious Puberty in Males: The Results of the Italian Study Group for Physiopathology of Puberty

Abstract

We reviewed the hospital records of 45 boys, followed in 13 pediatric departments throughout Italy, who had undergone computed tomography and/or magnetic resonance imaging for central precocious puberty (CPP). Twenty-seven patients (60%) had idiopathic CPP and 18 (40%) neurogenic CPP. A hamartoma of the tuber cinereum was found in six patients (33%). All patients with hypothalamic hamartoma had earlier onset of symptoms than patients with idiopathic CPP. Five patients (27%) were affected by type 1 neurofibromatosis, two had ependymoma and five patients had an intracranial anomaly. Basal LH and basal and peak LH/FSH ratio were greater, but not significantly, in boys with neurogenic CPP than in boys with idiopathic CPP. The highest LH peak levels were observed in patients with hamartoma; however, no correlation was observed between LH peak and the size of the hamartomas. In addition, bone age at diagnosis was more advanced in patients with hamartoma than in patients with other conditions. In conclusion, gonadotrophin-dependent precocious puberty may be of idiopathic origin or may occur in association with any CNS disorder. Further studies are needed in order to evaluate the effects of nutritional, environmental and psychosocial factors on the timing of sexual maturation, to explain the high incidence of idiopathic CPP in our male patients.

Changing Etiological Trends in Male Precocious Puberty: Evaluation of 100 Cases with Central Precocious Puberty over the Last Decade

“…Similar to the present study, Rizzo et al [3] found that an underlying organic cause was present in 25% of the cases; however, while Rizzo et al [3] evaluated only 12 male CPP cases, in the present study, 100 male cases were evaluated, which makes this study one of the most comprehensive studies with respect to the number of cases. The study by De Sanctis et al [15], which included 45 cases, found that the incidence of organic cases was 40%, while this rate is 48.7% in the review by Pigneur et al [16]. In our study, MRI showed that 77% of the cases with an organic pathology had space-occupying lesions, while 23% of the cases had developmental anomalies of CNS.…”

Boys with precocious or early puberty: incidence of pathological brain magnetic resonance imaging findings and factors related to newly developed brain lesions

“…The pathological CNS lesions responsible for CPP and PPP in our study were similar to those in previous studies20-23) (Table 4). The underlying disease of the youngest boy presenting with CPP in our study was a hypothalamic hamartoma, which was reported previously in a 7-month-old infant with PP24).…”

Gonadotropin-Releasing Hormone Analogue Treatment for Precocious Puberty

“…Hypothalamic hamartomas are responsible for CPP in 2-28% of patients [29,31]. These are congenital, non-neoplastic tumor-like lesions formed by heterotopic grey matter, neurons, glial cells and fiber bundles located at the base of the brain at the floor of the third ventricle, near to the tuber cinereum or to the mamillary bodies [32][33][34][35].…”