Figure 4
From: Gonadotropin-Dependent Precocious Puberty: Neoplastic Causes and Endocrine Considerations
(a) A 4-year-old female presented with Tanner III-IV breast development and bone age advancement to 11 years of age. Leuprolide stimulation (stimulated luteinizing hormone of 28 mIu/mL) confirmed gonadotropin-dependent precocious puberty. (b) MRI revealed an isointense mass (arrow) consistent with the diagnosis of a pedunculated hypothalamic hamartoma. This young girl's puberty has been adequately suppressed with depot leuprolide without further bone age advancement, pubertal development, neurologic sequelae, or mass changes on serial MRIs.