Abstract
Production of β-hCG is commonly seen in non-gestational chorio-carcinoma and considered a specific hormonal marker of this kind of neoplasm. More rarely ovarian germ cell tumors have been described producing β-hCG. A 4 11/12 yr old girl had a 2 yr long history of abdominal pain, bilateral breast development for 5 months and vaginal bleeding for 9 days. Examination showed a well developed girl with a height 112 cms, weight 21 kg (both at the 85th percentile), evidence of gonadarche (breast development Tanner 4, estrogenization of the external genitalia and vaginal bleeding), and no evidence of adrenarche (absent pubic hair= Tanner 1, not axillary odor nor hair). A large abdominal mass 15×20 cms was palpated. Bone age was 5 6/12 yrs. Pielography and ultrasound exams were consistant with an ovarian cystic mass. At laparotomy a 13×8×7 cms right ovarian cystic multiloculated tumor removed. By punction a citrine clear fluid was obtained which contained the following hormones: β-hCG >2,500 mIU/ml, LH 2.9 mIU/ml, FSH 2.0 mIU/ml, estradial 220 pg/ml, progesterone 40 ng/ml, 17-OHprogesterone >12 ng/ml, DHEA.SO4 54 ng/dl, and prolactin 9.8 ng/ml. The left ovary and uterus were reported “normal”. Histology was that of a granulosa cell tumor. All the abnormal clinical findings disappeared. We conclude: 1- The estrogen production of this tumor was the cause of the pseudoprecocious puberty, 2-This neoplasm had a self stimulatory mechanism by producing β-hCG, and 3-β-hCG is a potential hormonal marker for some types of granulosa cell tumors.
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Llano, M., Urdinola, J. & Vargas, A. 192 β-HUMAN CHORIONIC GONADOTROPIN (β-hCG) PRODUCEO BY A GRANULO CELL OVARIAN TUMOR CAUSING PSEUDOPRECOCIOUS PUBERTY. Pediatr Res 19, 635 (1985). https://doi.org/10.1203/00006450-198506000-00212
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DOI: https://doi.org/10.1203/00006450-198506000-00212