{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:28:59Z","timestamp":1784870939535,"version":"3.55.0"},"reference-count":94,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the impact of early exposure to androgen excess on gonadotropin-dependent puberty (GDP) and final height (FH) of patients with androgen-secreting adrenocortical tumors (ACT) in childhood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study. Occurrence of GDP and achievement of FH were evaluated. Central precocious puberty (CPP) and early fast puberty (EFP) were considered pubertal disorders. Patients with normal puberty and pubertal disorders were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 63 patients (44F), followed in a single institution from 1975 until 2017. At diagnosis of ACT, median age was 25.8 months; duration of signs, 6 months; stature SDS, 0.5 (\u22123.6 to 3.9) and bone age advancement, 14.7 months (\u221227.9 to 85.4). To date, 37 patients developed GDP: 26 had normal puberty; one, precocious thelarche; seven, CPP and three, EFP. GnRHa effectively treated CPP\/EFP. Tall stature and older age at diagnosis of ACT were associated with risk of CPP alone (RR 4.17 (95% CI 1.17\u201314.80)) and CPP\/EFP (RR 3.0 (95% CI 1.04\u20138.65)). Recurrence\/metastasis during follow-up were associated with risk of CPP alone (RR 4.17 (95% CI 1.17\u201314.80)) and CPP\/EFP (RR 3.0 (95% CI 1.12\u20138.02)). Among the 19 patients that reached FH, stature SDS dropped from 1.4 to \u22120.02 since diagnosis of ACT (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). Seventeen achieved normal FH. There was no difference in FH SDS between patients with normal puberty and pubertal disorders (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.75).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gonadotropin-dependent pubertal disorders are common in patients with androgen-secreting ACT in childhood. FH is usually not impaired. The study reinforces the importance of close follow-up after surgery to identify and treat consequences of early exposure to androgen excess.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-19-0141","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T11:26:07Z","timestamp":1554377167000},"page":"579-589","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":12,"title":["Gonadotropin-dependent pubertal disorders are common in patients with virilizing adrenocortical tumors in childhood"],"prefix":"10.1530","volume":"8","author":[{"given":"Monica F","family":"Stecchini","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilda","family":"Braid","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candy B","family":"More","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davi C","family":"Aragon","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Castro","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayrton C","family":"Moreira","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonir R","family":"Antonini","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"ref61","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1365-2265.2007.03160.x","article-title":"Long-term treatment of familial male-limited precocious puberty (testotoxicosis) with cyproterone acetate or ketoconazole","volume":"69","year":"2008","journal-title":"Clinical Endocrinology"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1586\/17446651.2014.941813","article-title":"Pediatric adrenocortical tumors: diagnosis, management and advancements in the understanding of the genetic basis and therapeutic implications","volume":"9","year":"2014","journal-title":"Expert Review of Endocrinology and Metabolism"},{"key":"ref651","first-page":"2027","article-title":"Childhood adrenocortical tumors","volume":"82","year":"1997","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4082\/kjfm.2015.36.3.150","article-title":"Virilizing adrenocortical carcinoma advancing to central precocious puberty after surgery","volume":"36","year":"2015","journal-title":"Korean Journal of Family Medicine"},{"key":"ref811","first-page":"43","article-title":"Evaluation of short and tall stature in children","volume":"92","year":"2015","journal-title":"American Family Physician"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000064767","article-title":"Growth in disorders of adrenal hyperfunction","volume":"58","year":"2002","journal-title":"Hormone Research"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1651-2227.2011.02338.x","article-title":"Clinical and metabolic findings in a 6-year-old boy with a Leydig cell tumour","volume":"100","year":"2011","journal-title":"Acta Paediatrica"},{"key":"ref151","first-page":"757","article-title":"Central precocious puberty after interpersonal transfer of testosterone gel: just a coincidence?","volume":"25","year":"2012","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"3106","DOI":"10.1210\/jc.2011-0363","article-title":"Wnt\/beta-catenin Pathway Deregulation in Childhood adrenocortical Tumors","volume":"96","year":"2011","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/j.1749-6632.1993.tb43873.x","article-title":"Congenital adrenal hyperplasia complicated by central precocious puberty: treatment with LHRH-agonist analogue","volume":"687","year":"1993","journal-title":"Annals of the New York Academy of Sciences"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1159\/000358084","article-title":"Gonadotropin-dependent precocious puberty in an 8-year-old boy with Leydig cell testicular tumor","volume":"82","year":"2014","journal-title":"Hormone Research in Paediatrics"},{"key":"ref291","first-page":"1061","article-title":"Adrenocortical tumor in a boy: final height is not impaired Despite a severe advancement of bone age","volume":"16","year":"2003","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref891","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1136\/adc.80.1.46","article-title":"Androgen secreting adrenocortical tumours","volume":"80","year":"1999","journal-title":"Archives of Disease in Childhood"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/j.1749-6632.1993.tb43873.x","article-title":"Congenital adrenal hyperplasia complicated by central precocious puberty: treatment with LHRH-agonist analogue","volume":"687","year":"1993","journal-title":"Annals of the New York Academy of Sciences"},{"key":"ref911","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/j.1365-2265.1982.tb01611.x","article-title":"Pubertal maturation of the LH stimulatory response to clomiphene citrate in congenital virilizing adrenal hyperplasia","volume":"17","year":"1982","journal-title":"Clinical Endocrinology"},{"key":"ref181","first-page":"2027","article-title":"Childhood adrenocortical tumors","volume":"82","year":"1997","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1136\/adc.80.1.46","article-title":"Androgen secreting adrenocortical tumours","volume":"80","year":"1999","journal-title":"Archives of Disease in Childhood"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1590\/2359-3997000000144","article-title":"Central precocious puberty: revisiting the diagnosis and therapeutic management","volume":"60","year":"2016","journal-title":"Archives of Endocrinology and Metabolism"},{"key":"ref551","first-page":"175","article-title":"Isosexual precocious pseudopuberty secondary to a testosterone-secreting Leydig cell testicular tumour: true isosexual development early after surgery","volume":"18","year":"1986","journal-title":"Andrologia"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1365-2265.2007.03160.x","article-title":"Long-term treatment of familial male-limited precocious puberty (testotoxicosis) with cyproterone acetate or ketoconazole","volume":"69","year":"2008","journal-title":"Clinical Endocrinology"},{"key":"ref771","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4082\/kjfm.2015.36.3.150","article-title":"Virilizing adrenocortical carcinoma advancing to central precocious puberty after surgery","volume":"36","year":"2015","journal-title":"Korean Journal of Family Medicine"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.jpeds.2012.05.039","article-title":"Leydig cell tumors in children: contrasting clinical, hormonal, anatomical, and molecular characteristics in boys and girls","volume":"161","year":"2012","journal-title":"Journal of Pediatrics"},{"key":"ref561","first-page":"1679","article-title":"Development of true precocious puberty following treatment of a Leydig cell tumor of the testis","volume":"14","year":"2001","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"9330","DOI":"10.1073\/pnas.161479898","article-title":"An inherited p53 mutation that contributes in a tissue-specific manner to pediatric adrenal cortical carcinoma","volume":"98","year":"2001","journal-title":"PNAS"},{"key":"ref521","first-page":"265","article-title":"Gonadotropin releasing hormone analog treatment in children with congenital adrenal hyperplasia complicated by central precocious puberty","volume":"14","year":"2015","journal-title":"Hormones"},{"key":"ref661","doi-asserted-by":"crossref","first-page":"4970","DOI":"10.1210\/jcem.86.10.7957","article-title":"An inherited mutation Outside the highly conserved DNA-binding domain of the p53 tumor suppressor protein in children and adults with sporadic adrenocortical tumors","volume":"86","year":"2001","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref401","first-page":"1137","article-title":"Precocious, early and fast puberty in males with Chiari I malformation","volume":"17","year":"2004","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.rx.2011.02.005","article-title":"Tumores corticosuprarrenales pedi\u00e1tricos: imagen de adenomas y carcinomas","volume":"54","year":"2012","journal-title":"Radiologia"},{"key":"ref851","year":"1959","journal-title":"Radiographic Atlas of Skeletal Development of the Hand and Wrist"},{"key":"ref881","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1200\/JCO.1990.8.1.67","article-title":"Adrenocortical carcinoma in children: a study of 40 cases","volume":"8","year":"1990","journal-title":"Journal of Clinical Oncology"},{"key":"ref31","first-page":"287","article-title":"Transient central precocious puberty in non-classic 21-hydroxylase deficiency","volume":"8","year":"1995","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref341","first-page":"43","article-title":"Evaluation of short and tall stature in children","volume":"92","year":"2015","journal-title":"American Family Physician"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S0026-0495(97)90186-4","article-title":"Congenital adrenal hyperplasia complicated by central precocious puberty: linear growth During infancy and treatment With gonadotropin-releasing hormone analog","volume":"46","year":"1997","journal-title":"Metabolism"},{"key":"ref231","first-page":"1","article-title":"Adrenocortical tumors associated with the TP53 p.R337H germline mutation can be identified during childhood","volume":"550","year":"2017","journal-title":"Jornal de Pediatria"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.canlet.2005.12.039","article-title":"The TP53 mutation, R337H, is associated with Li-Fraumeni and Li-Fraumeni-like syndromes in Brazilian families","volume":"245","year":"2007","journal-title":"Cancer Letters"},{"key":"ref641","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1136\/adc.67.2.234","article-title":"Growth patterns after surgery for virilising adrenocortical adenoma","volume":"67","year":"1992","journal-title":"Archives of Disease in Childhood"},{"key":"ref871","first-page":"1137","article-title":"Precocious, early and fast puberty in males with Chiari I malformation","volume":"17","year":"2004","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1590\/2359-3997000000144","article-title":"Central precocious puberty: revisiting the diagnosis and therapeutic management","volume":"60","year":"2016","journal-title":"Archives of Endocrinology and Metabolism"},{"key":"ref351","first-page":"95","article-title":"The use and abuse of growth standards","year":"1986","journal-title":"Human Growth"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-2007-1025405","article-title":"Growth in children with adrenocortical tumors","volume":"203","year":"1991","journal-title":"Klinische Padiatrie"},{"key":"ref831","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1136\/adc.44.235.291","article-title":"Variations in pattern of pubertal changes in girls","volume":"44","year":"1969","journal-title":"Archives of Disease in Childhood"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1136\/adc.67.2.234","article-title":"Growth patterns after surgery for virilising adrenocortical adenoma","volume":"67","year":"1992","journal-title":"Archives of Disease in Childhood"},{"key":"ref921","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000064767","article-title":"Growth in disorders of adrenal hyperfunction","volume":"58","year":"2002","journal-title":"Hormone Research"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1210\/jc.2002-021954","article-title":"In boys with abnormal developmental tempo, maturation of the skeleton and the hypothalamic-pituitary-gonadal axis remains synchronous","volume":"89","year":"2004","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"4970","DOI":"10.1210\/jcem.86.10.7957","article-title":"An inherited mutation Outside the highly conserved DNA-binding domain of the p53 tumor suppressor protein in children and adults with sporadic adrenocortical tumors","volume":"86","year":"2001","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref801","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1542\/peds.76.3.437","article-title":"Virilizing adrenocortical tumors in childhood: eight cases and a review of the literature","volume":"76","year":"1985","journal-title":"Pediatrics"},{"key":"ref861","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1210\/jcem.87.5.8481","article-title":"Gonadotropin-suppressive therapy in girls with early and fast puberty affects the pace of puberty but not total pubertal growth or final height","volume":"87","year":"2002","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1542\/peds.76.3.437","article-title":"Virilizing adrenocortical tumors in childhood: eight cases and a review of the literature","volume":"76","year":"1985","journal-title":"Pediatrics"},{"key":"ref381","year":"1959","journal-title":"Radiographic Atlas of Skeletal Development of the Hand and Wrist"},{"key":"ref141","first-page":"93","article-title":"True Precocious Puberty Following Treatment of a Leydig Cell Tumor: two case reports and literature review","volume":"3","year":"2015","journal-title":"Frontiers in Pediatrics"},{"key":"ref631","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1586\/17446651.2014.941813","article-title":"Pediatric adrenocortical tumors: diagnosis, management and advancements in the understanding of the genetic basis and therapeutic implications","volume":"9","year":"2014","journal-title":"Expert Review of Endocrinology and Metabolism"},{"key":"ref841","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/adc.45.239.13","article-title":"Variations in the pattern of pubertal changes in boys","volume":"45","year":"1970","journal-title":"Archives of Disease in Childhood"},{"key":"ref501","first-page":"287","article-title":"Transient central precocious puberty in non-classic 21-hydroxylase deficiency","volume":"8","year":"1995","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref71","first-page":"133","article-title":"Leydig cell tumours in childhood","volume":"16","year":"1983","journal-title":"Progress in Pediatric Surgery"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"9330","DOI":"10.1073\/pnas.161479898","article-title":"An inherited p53 mutation that contributes in a tissue-specific manner to pediatric adrenal cortical carcinoma","volume":"98","year":"2001","journal-title":"PNAS"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1159\/000151598","article-title":"Sexual pseudo-precocity caused by a somatic activating mutation of the LH receptor preceding true sexual precocity","volume":"70","year":"2008","journal-title":"Hormone Research"},{"key":"ref621","first-page":"757","article-title":"Central precocious puberty after interpersonal transfer of testosterone gel: just a coincidence?","volume":"25","year":"2012","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref821","first-page":"95","article-title":"The use and abuse of growth standards","year":"1986","journal-title":"Human Growth"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1136\/adc.44.235.291","article-title":"Variations in pattern of pubertal changes in girls","volume":"44","year":"1969","journal-title":"Archives of Disease in Childhood"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1210\/jcem.87.5.8481","article-title":"Gonadotropin-suppressive therapy in girls with early and fast puberty affects the pace of puberty but not total pubertal growth or final height","volume":"87","year":"2002","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S0026-0495(97)90186-4","article-title":"Congenital adrenal hyperplasia complicated by central precocious puberty: linear growth During infancy and treatment With gonadotropin-releasing hormone analog","volume":"46","year":"1997","journal-title":"Metabolism"},{"key":"ref721","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1158\/1078-0432.CCR-17-0408","article-title":"Cancer screening recommendations for individuals with li-fraumeni syndrome","volume":"23","year":"2017","journal-title":"Clinical Cancer Research"},{"key":"ref931","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-2007-1025405","article-title":"Growth in children with adrenocortical tumors","volume":"203","year":"1991","journal-title":"Klinische Padiatrie"},{"key":"ref611","first-page":"93","article-title":"True Precocious Puberty Following Treatment of a Leydig Cell Tumor: two case reports and literature review","volume":"3","year":"2015","journal-title":"Frontiers in Pediatrics"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.jpeds.2012.05.039","article-title":"Leydig cell tumors in children: contrasting clinical, hormonal, anatomical, and molecular characteristics in boys and girls","volume":"161","year":"2012","journal-title":"Journal of Pediatrics"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1159\/000358084","article-title":"Gonadotropin-dependent precocious puberty in an 8-year-old boy with Leydig cell testicular tumor","volume":"82","year":"2014","journal-title":"Hormone Research in Paediatrics"},{"key":"ref701","first-page":"1","article-title":"Adrenocortical tumors associated with the TP53 p.R337H germline mutation can be identified during childhood","volume":"550","year":"2017","journal-title":"Jornal de Pediatria"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1200\/JCO.1990.8.1.67","article-title":"Adrenocortical carcinoma in children: a study of 40 cases","volume":"8","year":"1990","journal-title":"Journal of Clinical Oncology"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1210\/jc.2013-1024","article-title":"Treatment and outcomes of precocious puberty: an update","volume":"98","year":"2013","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref741","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.rx.2011.02.005","article-title":"Tumores corticosuprarrenales pedi\u00e1tricos: imagen de adenomas y carcinomas","volume":"54","year":"2012","journal-title":"Radiologia"},{"key":"ref791","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.jpag.2017.05.009","article-title":"Central precocious puberty secondary to adrenocortical adenoma in a female child: case report and review of the literature","volume":"30","year":"2017","journal-title":"Journal of Pediatric and Adolescent Gynecology"},{"key":"ref51","first-page":"265","article-title":"Gonadotropin releasing hormone analog treatment in children with congenital adrenal hyperplasia complicated by central precocious puberty","volume":"14","year":"2015","journal-title":"Hormones"},{"key":"ref81","first-page":"175","article-title":"Isosexual precocious pseudopuberty secondary to a testosterone-secreting Leydig cell testicular tumour: true isosexual development early after surgery","volume":"18","year":"1986","journal-title":"Andrologia"},{"key":"ref751","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.mce.2011.10.015","article-title":"The International Pediatric Adrenocortical Tumor Registry initiative: Contributions to clinical, biological, and treatment advances in pediatric adrenocortical tumors","volume":"351","year":"2012","journal-title":"Molecular and Cellular Endocrinology"},{"key":"ref481","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1210\/jc.2013-1024","article-title":"Treatment and outcomes of precocious puberty: an update","volume":"98","year":"2013","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1651-2227.2011.02338.x","article-title":"Clinical and metabolic findings in a 6-year-old boy with a Leydig cell tumour","volume":"100","year":"2011","journal-title":"Acta Paediatrica"},{"key":"ref711","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.canlet.2005.12.039","article-title":"The TP53 mutation, R337H, is associated with Li-Fraumeni and Li-Fraumeni-like syndromes in Brazilian families","volume":"245","year":"2007","journal-title":"Cancer Letters"},{"key":"ref541","first-page":"133","article-title":"Leydig cell tumours in childhood","volume":"16","year":"1983","journal-title":"Progress in Pediatric Surgery"},{"key":"ref311","first-page":"503","article-title":"Pubertal outcome in a female with virilizing adrenocortical carcinoma","volume":"29","year":"2016","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"3106","DOI":"10.1210\/jc.2011-0363","article-title":"Wnt\/beta-catenin Pathway Deregulation in Childhood adrenocortical Tumors","volume":"96","year":"2011","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/j.1365-2265.1982.tb01611.x","article-title":"Pubertal maturation of the LH stimulatory response to clomiphene citrate in congenital virilizing adrenal hyperplasia","volume":"17","year":"1982","journal-title":"Clinical Endocrinology"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1159\/000151598","article-title":"Sexual pseudo-precocity caused by a somatic activating mutation of the LH receptor preceding true sexual precocity","volume":"70","year":"2008","journal-title":"Hormone Research"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.mce.2011.10.015","article-title":"The International Pediatric Adrenocortical Tumor Registry initiative: Contributions to clinical, biological, and treatment advances in pediatric adrenocortical tumors","volume":"351","year":"2012","journal-title":"Molecular and Cellular Endocrinology"},{"key":"ref91","first-page":"1679","article-title":"Development of true precocious puberty following treatment of a Leydig cell tumor of the testis","volume":"14","year":"2001","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1158\/1078-0432.CCR-17-0408","article-title":"Cancer screening recommendations for individuals with li-fraumeni syndrome","volume":"23","year":"2017","journal-title":"Clinical Cancer Research"},{"key":"ref731","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.humpath.2009.03.010","article-title":"The Weiss system for evaluating adrenocortical neoplasms: 25 years later","volume":"40","year":"2009","journal-title":"Human Pathology"},{"key":"ref781","first-page":"503","article-title":"Pubertal outcome in a female with virilizing adrenocortical carcinoma","volume":"29","year":"2016","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.humpath.2009.03.010","article-title":"The Weiss system for evaluating adrenocortical neoplasms: 25 years later","volume":"40","year":"2009","journal-title":"Human Pathology"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/adc.45.239.13","article-title":"Variations in the pattern of pubertal changes in boys","volume":"45","year":"1970","journal-title":"Archives of Disease in Childhood"},{"key":"ref761","first-page":"1061","article-title":"Adrenocortical tumor in a boy: final height is not impaired Despite a severe advancement of bone age","volume":"16","year":"2003","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"ref211","article-title":"Inheritance of R337H p53 gene mutation in children with sporadic adrenocortical tumor","year":"2005","journal-title":"Hormone and Metabolic Research"},{"key":"ref901","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1210\/jc.2002-021954","article-title":"In boys with abnormal developmental tempo, maturation of the skeleton and the hypothalamic-pituitary-gonadal axis remains synchronous","volume":"89","year":"2004","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref681","article-title":"Inheritance of R337H p53 gene mutation in children with sporadic adrenocortical tumor","year":"2005","journal-title":"Hormone and Metabolic Research"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.jpag.2017.05.009","article-title":"Central precocious puberty secondary to adrenocortical adenoma in a female child: case report and review of the literature","volume":"30","year":"2017","journal-title":"Journal of Pediatric and Adolescent Gynecology"}],"container-title":["Endocrine Connections"],"original-title":[],"link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/8\/5\/EC-19-0141.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/8\/5\/EC-19-0141.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:43:28Z","timestamp":1784555008000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/ec\/article\/8\/5\/579-589\/503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":94,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1530\/ec-19-0141","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]}}}