Central precocious puberty associated with duplicated pituitary: a case report and literature review

Abstract

Patients with duplicated pituitary often have severe neurodevelopmental abnormalities and craniofacial deformities. Till now, only eight patients diagnosed with duplicated pituitary showing barely central precocious puberty (CPP) are reported in the published literature. Herein, we report a 6-year-old and 3-month-old girl diagnosed with pituitary duplication presented with CPP. She has enlarged breasts for more than 1 year, accelerated height of linear growth, advanced bone age, increased hormone level, and increased volume of uterus and ovary. A duplicated pituitary gland was shown in the MRI. As the gonadotropin-releasing hormone analogue (GnRHa) stimulation test showed a positive result, the child was treated with GnRHa. After 2 years of follow-up, there was a delay in the progression of sexual development, a reduction in symptoms of precocious puberty, and an increase in predicted adult height.

Keywords: GnRHa; central precocious puberty (CPP); duplicated pituitary; female; height.

Figure 1

(A) Coronal plane scan of the pituitary gland: one pituitary gland is seen on each side of the sella turcica, and the two pituitary stalks walk in the shape of “八” (a Chinese character). (B), Sagittal scan of the pituitary gland: the shape of the hypothalamus is irregular, and the center of sella turcica becomes shallower.

Figure 2

Developmental abnormalities in 53 patients with duplicated pituitary.