Abstract
We report four episodes of unsustained precocious sexual development accompanied by palpable adnexal masses in three preschool aged girls. In each case serial pelvic ultrasound examinations revealed large ovarian cysts which spontaneously disappeared, with rapid regression of precocity, and fall in E2. At presentation, each girl had breast enlargement, labial hypertrophy with leukorrhea, hyperestrogenized vaginal cytology, and markedly elevated estradiol. Two patients had vaginal bleeding. None developed pubic hair. Patients 2 and 3 had negative cranial CT scans. Patient 2 had laparotomy which confirmed that ovaries had returned to normal. Patient 3 has been followed for 3.5 years without recurrance. Our data do not comment on whether these follicular cysts are truly autonomous since at least one patient had elevated gonadotrophins, but they do suggest that laparotomy and biopsy are not indicated in this situation when good ultrasonic surveillance is available.
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