Introduction: Precocious puberty represents a challenging condition. The golden standard for diagnosis of central precocious puberty (CPP) is Gonadotropin-Releasing Hormone (GnRH) test but its use does not limit the ultrasound value as a very good screening and prognosis tool.
Cases report: An 8-year girl with right nipple pain was examined using a 15 MHz linear probe which revealed an image of 10 mm under the skin, consistent with an incipient breast having 2 ducts. The ovaries were analyzed with a 7 MHz curved probe and revealed a right ovary with a length of 15 mm. Left ovary has a length of 21 mm. A Caucasian girl aged of 7 years and 9 months has idiopathic CPP based on clinical aspects (height +1.9 SD above the normal limit for age, breast Tanner stage of 2 3), bone age of 10 years and GnRH test results (peak LH after 4 hours of 2mUI mL, respective peak of estradiol after 24 hours of 112 pg mL). Breast ultrasound revealed right mammary gland of 2 mm with inhomogeneous aspect and left mammary gland of 6.1 m. The uterus at ultrasound examination had 28.5 11 18 mm, associating visible endometrial area of linear pattern, and multifollicle aspect of both ovaries sized of 25.5 by 15 mm.
Conclusion: Different ultrasound windows are needed for girls with precocious puberty; the lack of correlation between observations related to breast and uterus ultrasound gives us the opportunity to affirm that the breast is more sensitive to ovarian stimulation than the uterus.Full text sources