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Central precocious puberty after resection of a virilising adrenocortical oncocytic tumour
  1. Lee Rima Madi1,
  2. Naama Fisch Shvalb1,2,
  3. Chen Sade Zaltz1,3 and
  4. Yael Levy-Shraga1,4
  1. 1The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
  2. 2The Jesse and Sara Lea Shafer Institute of Endocrinology and Diabetes, Schneider Children's Medical Center, Petah Tikva, Israel
  3. 3The Department of Pathology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
  4. 4The Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
  1. Correspondence to Dr Yael Levy-Shraga; yael.levy.shraga{at}


Adrenocortical oncocytic tumours are a histological subtype of adrenal neoplasms with a distinctive morphological appearance. Since these tumours are composed of cells of the adrenal cortex, they may act as functional tumours with excess hormone production. They may cause Cushing’s syndrome, inappropriate virilisation or precocious puberty. Though rare during childhood, adrenocortical oncocytic tumours should be suspected in a child with peripheral precocious puberty and marked elevation of dehydroepiandrosterone sulfate levels. We describe a 6-year girl who presented with peripheral precocious puberty due to a functional adrenocortical oncocytic tumour. Three months after tumour removal, she developed true central precocious puberty. This report highlights that peripheral precocious puberty may trigger central precocious puberty, particularly after resolution of the underlying cause of the peripheral precocious puberty.

  • adrenal disorders
  • paediatrics

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  • Contributors LRM and YL-S participated in the data collection, drafted the initial manuscript and approved the final version as submitted. NFS and CSZ reviewed the initial manuscript, contributed to the case presentation and the discussion, and approved the final version as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.