Pathological brain lesions in girls with central precocious puberty at initial diagnosis in Southern Vietnam

Purpose: Cranial magnetic resonance imaging (MRI) is recommended to identify the existence of intracranial lesions in girls with central precocious puberty (CPP). Yet, the routine MRI scan in girls with CPP is still debatable, as the pathological finding in girls with CPP older than six years is limited. Therefore, we aimed to identify the prevalence of brain lessons stratified by age group (0-2, 2-6, and 6-8 years).

Methods: This retrospective cross-sectional study recruited 257 girls diagnosed with CPP for six years (2010-2016). MRI was used to detect brain abnormalities. Levels of luteinizing hormone, follicle-stimulating hormone, and sex hormones in blood samples were measured.

Results: Most girls had no brain lesions (82.9%, n=213), and a minor proportion of girls with CPP (17.1%, n=44) exhibited brain lesions, of which 32 girls had organic CPP. Pathological findings were detected in 33.3% (2/6) of girls aged 0-2 years, 15.6% (5/32) of girls aged 2-6 years, and 3.6% (8/219) of girls aged 6-8 years. Hypothalamic hamartoma and tumors in the pituitary stalk were the most common pathological findings. The likelihood of brain lesions decreased with age. Girls with organic CPP were more likely to be younger (6.1 ± 2.4 vs. 7.3 ± 1.3 years, P < 0.01) than girls with idiopathic CPP.

Conclusion: Older girls appeared to have a lower prevalence of organic CPP. Clinicians should cautiously use cranial MRI for girls aged 6-8 years with CPP.