Central Precocious Puberty Secondary to Peripheral Precocious Puberty Due to a Pineal Germ Cell Tumor: A Case and Review of Literature

The document discusses a case of a 5.8-year-old male who developed central precocious puberty (PP) due to a pineal germ cell tumor. The tumor was secreting human chorionic gonadotropin (HCG), causing peripheral PP. After chemoradiotherapy and surgery, the HCG levels normalized, but the levels of gonadotropins and testosterone increased, indicating a transition to central PP. This was managed with gonadotrophin-releasing hormone analog therapy. The document concludes that clinicians should be aware of the potential for secondary central PP in patients with pineal HCG-secreting tumors. An increase in gonadotropin levels prior to a decrease in sex steroids may indicate a transition to central PP related to melatonin.