Functional ovarian cysts can cause precocious puberty in children

Niu Niu is 3 years old this year. She is chubby and adorable, with delicate features. She is a beauty. Recently, Niu Niu's mother found that her breasts were obviously enlarged, so she took her to the Children's Hospital for examination.

Physical examination revealed that her breasts were bulging on both sides, with a relatively fixed, hard lump about 2cm×2cm in size felt inside, and no local redness, swelling or ulceration of the skin; the vulva was slightly developed, with a small amount of pigmentation on the labia minora, and a small amount of odorless leucorrhea-like secretion at the external opening of the vagina, with no local redness or swelling; there was no fever, frequent urination, urgency of urination, or vaginal bleeding.

Imaging and laboratory examinations: B-ultrasound examination showed a cystic mass in the right adnexal area, approximately 3.0cm×2.4cm×1.9cm in size, with a smooth inner wall, and normal uterus and left ovary; CT showed a low-density shadow in the right adnexal area, which was considered to be a liquid component; blood estradiol was 121.5pg/L, significantly higher than the normal level, follicle-stimulating hormone 0.12mIu/mL, and luteinizing hormone 0.07mIu/mL, significantly lower than the normal level.

The comprehensive diagnosis was functional ovarian cyst according to the examination results. After completing the preoperative examination, ovarian cystectomy was performed. During the operation, a white cyst with light yellow fluid was found in the right ovary. After the cyst was completely removed, it was sent for pathology, and the examination result was ovarian cystic follicle. After the operation, the child no longer had leucorrhea-like secretions, and the estradiol was re-examined <5pg/L. She recovered and was discharged from the hospital 2 weeks later.

The cause of ovarian cysts in children is still unclear. It is generally believed that it is related to the excessive stimulation of maternal estrogen and placental chorionic gonadotropin in the mother's womb, which fails to subside in time after birth. Ovarian cysts that have the function of autonomously secreting hormones and thus cause endocrine symptoms are called functional ovarian cysts. Children with this disease may develop precocious puberty. After the cause is removed, the estrogen level in the body will return to normal within 3 months, and the clinical symptoms of precocious puberty will gradually disappear.