Patient's question:
Breast has a hard lump, bone age 9 years, about 2 monthsDoctor's answer:
A detailed and complete medical history, including sexual development, vaginal bleeding patterns, and whether endocrine medications are being taken. Measuring follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the blood using radioimmunoassay can help differentiate between central and peripheral precocious puberty. In constitutional precocious puberty, ovarian enlargement with cystic changes may be observed. Suspected adrenal cortical disorders can be evaluated using retroperitoneal air contrast radiography. Anteroposterior and lateral views of the skull should be obtained to assess the size of the sella turcica and rule out tumors.