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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

LOZANO C., Claudia  y  MOLINA P., Marcela. Beta-hCG-producing thymic teratoma: an uncommon cause of peripheral precocious puberty. Rev. chil. pediatr. [online]. 2018, vol.89, n.3, pp.373-379. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41062018005000304.

Introduction:

Among the causes of peripheral precocious puberty in men are the beta- human cho rionic gonadotropin (Β-HCG)-secreting tumors, such as hepatoblastomas, dysgerminomas, chorio carcinomas, and immature teratomas. In pediatrics, the mediastinal teratomas are rare, representing the 7-10% of extragonadal teratomas.

Objective:

To describe the case of a patient with peripheral precocious puberty due to a Β-HCG -secreting thymic teratoma.

Clinical case:

A seven-years-old schoolboy presents a three-months history of voice changes, gynecomastia, pubic hair appearance, and increased genital volume. In the exams, bone age of nine years, total testosterone 9.33ng/ml (< 0.4ng/ml), dehydroepiandrosterone sulfate (DHEAS), 17-hydroxyprogesterone (17-OHP), and normal adrenocorticotropic hormone (ACTH) test stand out; luteinizing hormone (LH) and follicle stimulating hormone (FSH) with low basal levels, P-HCG 39.5mU/ml (< 2.5 mUI/ml), alpha feto protein (Α-FP) 11,2ng/ml (0.6-2.0 ng/ml). Imaging study to determine the origin of P-HCG secretion shows normal testicular ultrasound and thoracic, abdominal, and pelvic computerized axial tomo graphy (CAT); brain and sellar resonance without significant findings. The positron emission tomography/computed scan (PET SCAN) shows a tumor image in the anterosuperior mediastinum. The tumor is resected, and the biopsy shows an immature cystic teratoma in the thymus. Post-operatory evolution was satisfactory, with normalization of hormonal levels.

Conclusion:

The appearance of a teratoma in a pediatric patient is rare, even more if it is immature, with thymic location and Β-HCG- secretor. It is important to consider it within the differential diagnosis facing precocious puberty, as a better way to handle appropriately.

Palabras clave : Teratoma; precocious puberty; beta-human chorionic gonadotropin.

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