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A. M. HAIN, THE CONSTITUTIONAL TYPE OF PRECOCIOUS PUBERTY, The Journal of Clinical Endocrinology & Metabolism, Volume 7, Issue 3, 1 March 1947, Pages 171–185, https://doi.org/10.1210/jcem-7-3-171
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Abstract
“CONSTITUTIONAL”is the term used by Novak (28) to describe a type of precocious puberty for which no adequate cause has yet been found. This does not mean that a pathologic condition may not exist but that all the known conditions associated with sexual precocity have been excluded in the cases in question. Such conditions are the following:
- (a)
Granulosa-cell tumor of which there have been fully sixteen instances of its association with precocious puberty, Novak (28); three of these are described by Novak (27). An interesting observation made by this author (28) is that menstruation in such individuals, being of the estrogen-induced type is always anovulatory, which is in contrast with that of the so-called “constitutional” type; in one of the children to be described later on, pregnanediol was being excreted, showing that ovulation had occurred.
- (b)
Sexual precocity of the cerebral type has been recorded in seventeen cases (Weinberger and Grant (37)) in all of which lesions of the hypothalamus and third ventricle were present; girls are rarely affected with this lesion, though cases have been recorded by Dott (8), Bing, et al., (2) and by Gross (13) (his case 7). Ford and Guild (11) describe precocious puberty in two girls, aged 9, following measles encephalomyelitis and in a boy, aged 11, following epidemic encephalitis. These authors give a useful review of precocity due to brain tumors and add 7 cases to be ascribed to hypothalamic lesions caused by inflammatory processes; furthermore it is well recognized that in cases of hydrocephalus a degree of sexual precocity frequently exists. Pineal tumors have been held to cause precocious puberty in boys but the sum of evidence to date (31) not only shows that the pineal gland is not a secretory structure but that the tumors in this region produced their effects either by their nature, e.g., as embryonal tumors, teratomas or mixed tumors or by their pressure effects on the hypothalamus or its nervous connections.
