Gonadotropin independent precocious puberty.

Clinicians should now be fully aware of this intriguing condition of GIPP. The condition is characterized by pubertal sex steroid concentrations and gametogenesis in the presence of prepubertal or suppressed gonadotrophins. In patients with MPP especially without a family history, one should exclude the possibility of pseudoprecocious puberty due to premature production of sex steroids without pituitary gonadotrophins resulting from a primary disorder of the gonad or adrenal gland or to autonomous secretion of gonadotrophin by a tumor. Similarly in patients with recurrent ovarian cyst formation, persistence of the cysts especially with a significant solid component beyond three months should alert a clinician to the possibility of juvenile granulosa cell tumor of the ovary /75/. After confirmation of the diagnosis appropriate treatment should be instituted.