Treatment of Precocious Pseudopuberty Associated With Follicular Cysts of the Ovary

Undetectable levels of serum FSH immunoactivity and bioactivity in girls with sexual precocity due to ovarian cysts

“…Occasionally, large ovarian cysts capable of secreting oestrogen can cause precocious sexual development in girls. The suppressed gonadotrophin concentrations in these girls indicates that these cysts are functioning autonomously, independent of pituitary gonadotrophin stimulation (4)(5)(6)(7)(8) and therefore these girls can be distinguished from girls with central precocious puberty or premature thelarche. With involution or surgical removal of the cyst, vaginal bleeding occurs because of oestrogen withdrawal, followed by regression of the pubertal changes.…”

“…In contrast, patients with central precocious puberty present with accelerated growth, rapid skeletal maturation, elevated serum oestradiol and a LH-predominant response to LHRH. Transient or sustained sexual precocity in girls with suppressed serum gonadotrophin responsiveness to LHRH due to autonomous secretion of oestrogen from ovarian cysts have been described, often in association with the McCune-Albright syndrome (2)(3)(4)(5)(6)(7)(8). Girls with transient sexual precocity due to ovarian cyst can be differentiated clinically from girls with premature thelarche because of the occurrence of vaginal bleeding in most of the reported cases.…”