Jordanian Girl with Juvenile Granulose Cell Tumor Presented as Precocious Puberty: A Case Report

Objective: Our objective is to explain precocious puberty, type, etiology, investigation, how to differentiate between central and peripheral precocious puberty, and focus on one of the rarest causes of precocious puberty. Case report: In our case of precocious puberty, a two-year-old female presented with bilateral breast enlargement, vaginal secretion, pubic hair, and abdominal swelling. An abdominal and pelvic CT shows a very large ovarian mass. Asalpino-oophorectomy was carried out with regression of symptoms and signs and improvement in laboratory exams. The biopsy showed Juvenile Granulosa Cell Tumors (JGCT). Discussion: Due to an increase in the levels of estradiol and no increase in the gonadotropins (LH, FSH), advanced bone age and height age are compatible with the chronic age of 2 years old, so we think about peripheral precocious puberty. Due to abdominal swelling and patient age (small age), we suspect malignancy, so we did a CT scan and sonography of the pelvis. Conclusion: Every patient with signs and symptoms of precocious puberty must do all the investigation that leads to diagnosis, especially when there is a red flag like in our patient (very small age).