{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:34Z","timestamp":1787017954911,"version":"build-2736575974"},"reference-count":31,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Res Paediatr"],"abstract":"<jats:p>Introduction: \u03b2-human chorionic gonadotrophin (\u03b2-hCG) secreting tumors causing gonadotropin-independent precocious puberty (GIPP) are rare. This case underscores the diagnostic difficulties presented by these tumors. Case Presentation: A 10.8-year-old boy was referred with rapidly advancing puberty. He had Tanner stage 5 pubic hair, macropenis, accelerated growth and bone age. Suppressed gonadotropins with elevated testosterone and \u03b2-hCG levels led to diagnosis of GIPP. Cranial imaging for the source of \u03b2-hCG identified a 7-mm pituitary adenoma; however, resection of the pituitary lesion and petrosal sinus and cerebrospinal fluid \u03b2-hCG measurements did not support this. A testicular biopsy and spermatic venous \u03b2-hCG levels due to testicular calcifications indicated no evidence of testicular secretion. PET\/CT demonstrated mild fluorodeoxyglucose uptake in the thymic region. Excisional biopsy was consistent with thymic hyperplasia. During follow-up, \u03b2-hCG levels fluctuated between 100 and 154 mIU\/mL, with serial imaging (cranial, thoraco-abdomino-pelvic magnetic resonance imaging) remaining unremarkable. At sixth year of follow-up, \u03b2-hCG surged to 2,039 mIU\/mL, at which time, thoracic CT revealed a 5 cm mass in the mediastinum. The mass was resected and pathology was consistent a mixed germ cell tumor. Conclusion: The source of \u03b2-hCG may remain obscure for a long time in \u03b2-hCG-mediated GIPP. Ongoing surveillance is essential in similar cases.<\/jats:p>","DOI":"10.1159\/000549889","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T17:01:20Z","timestamp":1764781280000},"page":"1-10","source":"Crossref","is-referenced-by-count":1,"title":["The Mystery of Elevated \u03b2-hCG in GnRH-Independent Precocious Puberty without a Detectable Tumor: A Six-Year Diagnostic 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