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Precocious puberty as initial presentation in mediastinal tumour.

Manjusha Nair1, P Kusumakumary, Anu Ninan

  • 1Division of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India. drmanjushanair@gmail.com

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Summary

Germ cell tumours (GCTs) are a rare cause of precocious puberty in children. This report details two successful cases of aggressive treatment for mediastinal malignant GCTs presenting with this condition.

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Area of Science:

  • Pediatric Oncology
  • Endocrinology
  • Tumor Biology

Background:

  • Precocious puberty, or early onset of puberty, can stem from various conditions.
  • Germ cell tumours (GCTs) are an uncommon but significant etiology for precocious puberty.
  • Mediastinal GCTs are particularly rare, especially in pediatric populations.

Observation:

  • Two pediatric patients presented with precocious puberty attributed to mediastinal malignant GCTs.
  • Both cases involved bulky, advanced-stage disease at diagnosis.
  • Clinical presentation included rapid pubertal development in both children.

Findings:

  • Aggressive neoadjuvant chemotherapy followed by surgical resection was the treatment strategy.
  • Both patients achieved complete remission and remain disease-free.
  • Successful management of advanced mediastinal GCTs leading to precocious puberty was demonstrated.

Implications:

  • Highlights the importance of considering rare causes like GCTs in pediatric precocious puberty.
  • Demonstrates the efficacy of multimodal treatment for advanced mediastinal GCTs.
  • Offers a potential therapeutic pathway for similar rare pediatric malignancies.