Peripheral precocious puberty with unilateral ovarian agenesis in early childhood: a case report and review of literature.
Elene Asanidze, Alla Vash-Margita, Besik Asanidze et al.
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Case in brief
A 2-year and 10-month-old girl presented with breast development, pubarche, and recurrent vaginal bleeding. Imaging revealed a cyst in the left ovary and agenesis of the right ovary. Laparoscopy confirmed the absence of the right ovary and ipsilateral fallopian tube. A diagnosis of peripheral precocious puberty due to a functional ovarian cyst was made, leading to an ovarian-preserving laparoscopic cystectomy. Postoperatively, there was partial regression of pubertal signs and resolution of vaginal bleeding.
What made this case unusual
The coexistence of peripheral precocious puberty and unilateral ovarian agenesis in a single patient is extremely rare, presenting unique diagnostic and management challenges.
Diagnostic / clinical pearl
Clinicians should consider the possibility of functional ovarian cysts in cases of peripheral precocious puberty, especially when congenital anomalies like unilateral ovarian agenesis are present.
Why it matters
This case underscores the need for individualized management strategies in pediatric patients with precocious puberty, particularly when congenital anomalies complicate the clinical picture.