Precocious pseudopuberty due to ovarian causes.

BACKGROUND It is important to differentiate central from peripheral causes of precocious puberty because of distinct management options. CASE CHARACTERISTICS 4 girls with discordant pubertal development. OBSERVATIONS All had low basal and GnRHa stimulated FSH and LH level with high estradiol level. Abdominal ultrasonogram helped in diagnosing precocious pseudopuberty- ovarian cyst in 3 children and juvenile granulosa cell tumour in one. OUTCOME Case 1 and 4 underwent surgery in view of persistent cyst and tumor, respectively. Rest were managed conservatively. Regression of pubertal signs observed in all children during follow-up. CONCLUSION Precocious pseudopuberty can be differentiated from central precocious puberty by GnRHa Stimulation test, bone age and abdominal ultrasound.