ABSTRACT
Background: It is important to differentiate central from peripheral causes of precocious puberty because of distinct management options. Case Characteristics: 4 girls with discordant pubertal development. Observations: All had low basal and GnRHa stimulated FSH & LH level with high estradiol level. Abdominal ultrasonogram helped in diagnosing precocious pseudopuberty- ovarian cyst in 3 children and juvenile granulosa cell tumour in one. Outcome: Case 1 and 4 underwent surgery in view of persistent cyst and tumor, respectively. Rest were managed conservatively. Regression of pubertal signs observed in all children during follow-up. Conclusion: Precocious pseudopuberty can be differentiated from central precocious puberty by GnRHa Stimulation test, bone age and abdominal ultrasound.