Sexual precocity in girls is defined as the appearance of secondary sexual characteristics before the age of 7½ years or menstruation before 8 years of age. In this issue of the AJDC, Kosloske et al1 have reported two cases of isosexual precocity associated with small (9 and 11 mm in diameter), unilateral ovarian cysts. Both patients had a one-month history of breast tenderness and development of 1- to 2-cm breast buds; sexual hair was not present in either case. From this limited experience, Kosloske and colleagues1 suggest that if pelvic ultrasonography identifies an ovarian mass, either solid or cystic, and a serum estrogen level is increased, an exploratory laparotomy should be performed. Their aggressive, and we believe questionable, conclusion should challenge each of us to make every reasonable attempt to define the specific cause of the sexual precocity; otherwise, their recommendation would require surgical exploration of all patients who
LIGHTNER ES, KELCH RP. Treatment of Precocious Pseudopuberty Associated With Ovarian Cysts. Am J Dis Child. 1984;138(2):126–128. doi:10.1001/archpedi.1984.02140400012002
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