Figure 1

(a) A 3-year-old male presented with Tanner II pubic hair, testicular enlargement (~6 mL bilaterally), facial hair, and acne. Laboratory evaluation was consistent with gonadotropin-dependent sexual precocity. (b) MRI revealed a large suprasellar mass (arrows) with both solid and cystic components. The normal pituitary (arrowhead) is also visualized. Pathology confirmed a juvenile pilocytic astrocytoma.