Peripheral Precocious Puberty Caused by Human Chorionic Gonadotropin Producing Pineal Gland Tumor

Background: Pineal gland lesions usually present with central precocious puberty.Case characteristics: A 3½-yr-old boy presented with precocious puberty. Clinically andbiochemically, it was gonadotropin releasing hormone (GnRH) independent. Serum andCSF beta-hCG levels were increased. Thin section magnetic resonance imaging of brainrevealed a pineal gland tumor. Outcome: He received chemotherapy followed byradiotherapy and responded well. Message: CSF ?-hCG should be measured in all cases ofperipheral precocity, and if CSF beta-hCG is elevated, thin section magnetic resonanceimaging of brain should be considered.