"Double Trouble": A case of precocious puberty with concomitant malignant gluteal mass

@#Precocious puberty is the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The causes may range from a variant of normal development to pathologic conditions such as glands that function abnormally early in life. This is a case of a seven year old female with clitoromegaly, early menarche and a gluteal mass accompanied by elevated 17-hydoxyprogesterone and decreased level of cortisol which supports the diagnosis of congenital adrenal hyperplasia. Gluteal mass cytological features are consistent with a malignant round cell tumor.