{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T17:28:12Z","timestamp":1684517292170},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:p>Medulloblastoma is a malignant embryonal tumor that arises in the cerebellum and invades the fourth ventricle, often resulting in obstructive hydrocephalus. Patients typically present with symptoms related to increased intracranial pressure and cerebellar dysfunction. The authors report a rare case of classic medulloblastoma with central precocious puberty (CPP) as its only presenting symptom.<\/jats:p>\n<jats:p>A 7-year-old boy with no prior history of medulloblastoma presented with Tanner Stage IV testicular enlargement and a 4-month history of acne and pubic hair. Laboratory tests of blood samples demonstrated highly elevated luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. Admission MRI of the brain revealed a mass in the posterior fossa, which bordered and compressed the fourth ventricle. The patient also exhibited mild lateral and third ventriculomegaly. Surgical options were discussed with the neurosurgical department.<\/jats:p>\n<jats:p>A suboccipital craniotomy and C-1 laminectomy were performed. A large mass was seen arising from the inferior surface of the vermis, and lying within the fourth ventricle. Gross-total microsurgical resection of the mass was performed. Histopathological investigation characterized the tumor as classic medulloblastoma. Follow-up laboratory tests of blood samples demonstrated a reduction of LH, FSH, and testosterone back to prepubertal levels. The patient then began radiation and chemotherapy.<\/jats:p>\n<jats:p>This report demonstrates that mild obstructive hydrocephalus due to a posterior fossa tumor may present with unexpected symptoms, such as CPP. To the authors\u2019 knowledge, precocious puberty has not yet been associated with medulloblastoma, although it has been found with other posterior fossa tumors. Extensive imaging of the CNS for patients presenting with CPP is recommended.<\/jats:p>","DOI":"10.3171\/2015.1.peds14358","type":"journal-article","created":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T17:20:55Z","timestamp":1433956855000},"page":"287-290","source":"Crossref","is-referenced-by-count":2,"title":["Resolution of precocious puberty following resection of fourth ventricular medulloblastoma: case report"],"prefix":"10.3171","volume":"16","author":[{"given":"Renata G.","family":"Medina","sequence":"first","affiliation":[{"name":"School of Medicine, Saint Louis University;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Dempsher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Endocrinology;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M.","family":"Gauvain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology-Oncology, Washington University in St. Louis School of Medicine, Saint Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J.","family":"Geller","sequence":"additional","affiliation":[{"name":"Department of Neurology and Psychiatry, Division of Child Neurology; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samer K.","family":"Elbabaa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Saint Louis University School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds14358","series-title":"Curr Opin Oncol","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1097\/CCO.0b013e32834ace3f","article-title":"Medulloblastomas: update on a heterogeneous disease","volume":"23","author":"Bourdeaut","year":"2011"},{"key":"b2-peds14358","series-title":"Indian Pediatr","first-page":"321","article-title":"Precocious puberty\u2014unusual manifestation of cerebellar astrocytoma","volume":"14","author":"Chopra","year":"1977"},{"key":"b3-peds14358","series-title":"J Child Neurol","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.1177\/0883073809341668","article-title":"Medulloblastoma","volume":"24","author":"Dhall","year":"2009"},{"key":"b4-peds14358","series-title":"Eur J Pediatr","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s004310050672","article-title":"Auxological and endocrinological evaluation of children with hydrocephalus and\/or meningomyelocele","volume":"156","author":"Hochhaus","year":"1997"},{"key":"b5-peds14358","series-title":"Pediatric Endocrinology","first-page":"662","article-title":"The testes: disorders of sexual differentiation and puberty in the male","author":"Hughes","year":"2008"},{"issue":"1 Suppl","key":"b6-peds14358","series-title":"J Neurosurg","first-page":"66","article-title":"Cerebellar astrocytoma presenting with precocious puberty in a girl. Case report","volume":"107","author":"Josan","year":"2007"},{"key":"b7-peds14358","series-title":"Acta Neuropathol","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s00401-007-0243-4","article-title":"The 2007 WHO classification of tumours of the central nervous system","volume":"114","author":"Louis","year":"2007"},{"key":"b8-peds14358","series-title":"Pediatr Clin North Am","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/S0031-3955(03)00206-2","article-title":"Neurosurgical treatment of brain tumors in children","volume":"51","author":"Maher","year":"2004"},{"key":"b9-peds14358","series-title":"J Pediatr Adolesc Gynecol","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/S1083-3188(00)86628-0","article-title":"Effects of puberty on bone age maturation in a girl after medulloblastoma therapy","volume":"12","author":"Marx","year":"1999"},{"key":"b10-peds14358","series-title":"J Neurosurg Sci","first-page":"81","article-title":"Endocrine disorder as the only sign of chronic \u201cnon-hypertensive\u201d hydrocephalus","volume":"46","author":"Morello","year":"2002"},{"key":"b11-peds14358","series-title":"Nat Clin Pract Oncol","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1038\/ncponc0794","article-title":"Medulloblastoma: tumorigenesis, current clinical paradigm, and efforts to improve risk stratification","volume":"4","author":"Polkinghorn","year":"2007"},{"key":"b12-peds14358","series-title":"Arch Dis Child","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1136\/adc.75.1.42","article-title":"Increased perinatal intracranial pressure and prediction of early puberty in girls with myelomeningocele","volume":"75","author":"Proos","year":"1996"},{"key":"b13-peds14358","series-title":"Fetal Pediatr Pathol","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1080\/15227950590961207","article-title":"Sexual precocity: a historical perspective and update","volume":"24","author":"Root","year":"2005"},{"key":"b14-peds14358","series-title":"Williams Textbook of Endocrinology","first-page":"1054","article-title":"Puberty: ontogeny, neuroendocrinology, physiology, and disorders","author":"Styne","year":"2011"},{"key":"b15-peds14358","series-title":"Endocr Rev","first-page":"111","article-title":"Neurobiological mechanisms of the onset of puberty in primates","volume":"22","author":"Terasawa","year":"2001"},{"key":"b16-peds14358","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1111\/j.1365-2265.2006.02582.x","article-title":"Presentation and evolution of organic central precocious puberty according to the type of CNS lesion","volume":"65","author":"Trivin","year":"2006"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/16\/3\/article-p287.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/16\/3\/article-p287.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/16\/3\/article-p287.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T11:59:11Z","timestamp":1681559951000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/16\/3\/article-p287.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":16,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2015.1.peds14358","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}