Neoplastic causes of abnormal puberty. Issue 4 (24th October 2013)

• Record Type: Journal Article
• Authors: Wendt, Susanne; Shelso, John; Wright, Karen; Furman, Wayne
• Is Part Of: Pediatric blood & cancer. Volume 61:Issue 4(2014:Apr.)
• Page Start: 664
• Page End: 671
• Publication Date: 2013-10-24
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.24825
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="pbc24825-sec-0001" sec-type="section"> <title>Background</title> <p>Neoplasm‐related precocious puberty (PP) is a rare presenting feature of childhood cancer. Moreover, evaluation of suspected PP in a child is complex, and cancer is often not considered. We characterized the clinicopathologic features of patients presenting with PP at a large pediatric cancer center, reviewed the relevant literature, and developed an algorithm for the diagnostic work‐up of these patients.</p> </sec> <sec id="pbc24825-sec-0002" sec-type="section"> <title>Methods</title> <p>We examined the records of all patients with a neoplasm and concomitant PP treated at St. Jude Children's Research Hospital from January 1975 through October 2011, reviewed the available literature, and analyzed the demographic, clinical, endocrine, and neoplasm‐related features.</p> </sec> <sec id="pbc24825-sec-0003" sec-type="section"> <title>Results</title> <p>Twenty‐four of 13, 615 children and adolescents (0.18%) were diagnosed with PP within 60 days of presentation. Primary diagnoses included brain tumor (12), adrenocortical carcinoma (5), hepatoblastoma (4), and others (3). PP was observed 0–48 months before diagnosis of neoplasm; 17 patients had peripheral PP and 7 had central PP.</p> </sec> <sec id="pbc24825-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Neoplasm‐related PP is rare and takes the form of a paraneoplastic syndrome caused by tumor production of hormones or by alteration of physiologic gonadotropin production. PP can precede diagnosis of malignancy by months or years, and neoplastic causes should be considered early to avoid delayed cancer diagnosis. Treatment of the primary malignancy resolved or diminished PP in surviving patients with an intact hypothalamic–pituitary–gonadal axis. Pediatr Blood Cancer 2014;61:664–671. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>