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Juvenile granulosa cell tumor of the ovary presenting as isosexual precocious puberty

Cyriel Anthony I. Tingne, MD; Agnes L. Soriano-Estrella, MD, FPOGS, FPSSTD, MHPEd
Department of Obstetrics and Gynecology, Philippine General Hospital

Isosexual precocious puberty is rare and a thorough investigation must be done in order to identify the cause of the precocity. This paper presents the case of a 4 year-old girl who was brought to the emergency room due to vaginal bleeding associated with onset of secondary sexual characteristics. Estradiol and anti-mullerian hormone levels were elevated. Abdominal ultrasound revealed an abdominopelvic mass probably an ovarian new growth with benign sonologic features. Computer tomography of the brain with contrast showed normal findings. Elective surgery was planned after correction of the anemia and other causes of precocious puberty were excluded. She underwent an exploratory laparotomy and left salpingooophorectomy with frozen section. Final histopathology report showed juvenile granulosa cell tumor of the left ovary.