{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T07:01:35Z","timestamp":1769238095346,"version":"3.49.0"},"reference-count":15,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Gonadotropin-releasing hormone (GnRH(-independent premature puberty in boys, characterized by elevated \u03b2-human chorionic gonadotropin (\u03b2-hCG) levels, can indicate a secreting germ cell tumor (GCT). These tumors are rare but more common in individuals with Klinefelter syndrome (KS). We present a case of a 7.3-year-old boy with precocious puberty. Physical examination revealed bilateral testicular volumes of 8 to 10\u2005mL and Tanner stage 3 secondary sexual characteristics (genitalia G3, pubic hair P3). His skeletal age was 12 years. Biochemical tests showed suppressed gonadotropin levels, elevated testosterone, and increased \u03b2-hCG of 86.6\u2005mIU\/mL (86.6\u2005IU\/L, reference range: &amp;lt;5\u2005mIU\/mL, &amp;lt;5\u2005IU\/L). Imaging, including magnetic resonance imaging (MRI), chest x-ray, whole-body computed tomography (CT), and testicular ultrasound, were interpreted as normal except for a small pineal cyst. Karyotype testing confirmed KS. Over 10 months, \u03b2-hCG levels fluctuated between 1 to 105\u2005mIU\/mL (1-105\u2005IU\/L). When \u03b2-hCG was 3.6\u2005mIU\/mL (3.6 IU\/L), a fluorodeoxyglucose positron emission tomography\u2013CT (FDG PET-CT) scan revealed a mediastinal tumor. The tumor was surgically removed and identified as a mature teratoma. This case underscores the importance of karyotype testing and repeated imaging in boys with premature puberty and elevated \u03b2-hCG levels, even if \u03b2-hCG levels decrease spontaneously and remain low.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae169","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T08:46:33Z","timestamp":1727426793000},"source":"Crossref","is-referenced-by-count":1,"title":["Mediastinal Tumor in a Boy With GnRH-Independent Precocious Puberty and Fluctuating \u03b2-HCG Levels"],"prefix":"10.1210","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2399-1866","authenticated-orcid":false,"given":"Smadar","family":"Shilo","sequence":"first","affiliation":[{"name":"The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petah Tikva 4920235 ,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv-Yafo 6997801 ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirah","family":"Amar","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Schneider Children's Medical Center of Israel , Petah Tikva 4920235 ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noa","family":"Shefer Averbuch","sequence":"additional","affiliation":[{"name":"The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petah Tikva 4920235 ,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv-Yafo 6997801 ,","place":["Israel"]},{"name":"The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus , Petah Tikva 4941492 ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efraim","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Leumit Health Services , Beit Shemesh 9909003 ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6616-5612","authenticated-orcid":false,"given":"Moshe","family":"Phillip","sequence":"additional","affiliation":[{"name":"The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petah Tikva 4920235 ,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv-Yafo 6997801 ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liora","family":"Lazar","sequence":"additional","affiliation":[{"name":"The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petah Tikva 4920235 ,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv-Yafo 6997801 ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"issue":"2","key":"2024101805230754200_luae169-B1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1210\/jcem.84.2.5533","article-title":"Precocious puberty: who has it? 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