Pineal cysts in children with precocious puberty: Is it a coincidental finding?

Yıl 2022, , 315 - 321, 30.06.2022

Saliha Çıracı , Recep Polat

https://doi.org/10.31832/smj.1060348

Cited By: 1

Öz

Objective: The aim of this study is to assess the correlation between precocious puberty and pineal cysts in children.
Materials and methods: The brain MRI scans of 122 patients with precocious puberty and 122 children in control group were evaluated for the presence and size of pineal cysts. Pineal cysts were assessed as true cyst and cystic transformation in terms of their sizes. The presence of pineal cysts/cystic transformation was compared between the two groups. In the precocious puberty group, the baseline and peak LH levels of patients with pineal cyst, cystic transformation and no cyst-cystic transformation were compared.
Results: The chi-square test indicated no significant correlation between precocious puberty and pineal cyst, and between precocious puberty and pineal cystic transformation (p=0.2537 and p=0.8797 respectively). There was no significant difference in the basale and peak LH levels between the patients with pineal cyst, cystic transformation and no cyst-cystic transformation in the precocious puberty group (p=0.566 and p= 0.367 respectively).
Conclusion: According to the results of the present study, there was no correlation between pineal cysts and precocious puberty. Therefore, it is a correct approach to accept pineal cysts detected in MRI scans as incidental findings in cases with precocious puberty.

Anahtar Kelimeler

precocious puberty, pineal cyst, melatonina, magnetic resonance imaging

Erken puberte tanılı olgularda epifiz kistleri: Tesadüfi bir bulgu mu?

Öz

Amaç: Bu çalışmanın amacı, çocuklarda erken puberte ile pineal kistler arasındaki ilişkinin değerlendirilmesidir.
Gereç ve Yöntemler: Erken puberte tanılı 122 olgu ve 122 kontrol grubu çocuğun beyin MR görüntüleri pineal kist varlığı ve boyutları açısından değerlendirildi. Pineal kistler boyutlarına göre gerçek kist ve kistik transformasyon olarak değerlendirildi. Erken puberte ve kontrol grubu pineal kist/kistik transformasyon varlığı açısından karşılaştırıldı. Erken puberte grubunda pineal kist saptanan, kistik transformasyon saptanan ve kist/kistik transformasyon saptanmayanların pik ve bazal LH değerleri karşılaştırıldı.
Bulgular: Ki-kare testi ile erken puberte ile pineal kist arasında ve erken puberte ile pineal kistik transformasyon arasında anlamlı ilişki saptanmadı (sırasıyla p=0,2537ve p=0,8797). Erken puberte grubunda kist/kistik transformasyon izlenmeyen, kistik transformasyon saptanan ve kist saptananlar arasında pik ve bazal LH değerleri açısından anlamlı farklılık bulunmadı (sırasıyla p=0,566 ve p=0,367).
Sonuç: Çalışmamızın sonuçlarına göre , pineal kistler ile erken puberte arasında herhangi bir ilişki saptanmamıştır. Bu nedenle, erken puberte tanılı olgularda MR incelemelerde saptanan pineal kistlerin insidental bulgu olarak kabul edilmeleri doğru bir yaklaşımdır.

Anahtar Kelimeler

erken puberte, pineal kist, melatonin, manyetik rezonans görüntüleme

Kaynakça

• 1. Klein KO. Precocious puberty: who has it? Who should be treated? J Clin Endocrinol Metab 1999;84:411-414.
• 2. Fahmy JL, Kaminsky CK, Kaufman F, Nelson Jr MD, Parisi MT. The radiological approach to precocious puberty. Br J Radiol 2000;73:560-567.
• 3. Soriano-Guillén L, Argente J. Central precocious puberty, functional and tumor-related. Best Pract Res Clin Endocrinol Metab 2019;33:101262.
• 4. Ojeda SR, Lomniczi A, Mastronardi C, Heger S, Roth H, Ebeveyn AS, et al. Minireview: the neuroendocrine regulation of puberty: is the time ripe for a systems biology approach? Endocrinology 2006;147:1166e74.
• 5. Herbison AE. Control of puberty onset and fertility by gonadotropin-releasing hormone neurons. Nat Rev Endocrinol 2016;12:452e66.
• 6. Rivarola G, Belgorosky A, Mendilaharzu H, Vidal G. Precocious puberty in children with tumours of the suprasellar and pineal areas: organic central precocious puberty. Acta Paediatr 2001; 90:751-756.
• 7. Cnossen MA, Stam EN, Cooiman LC, Simonsz HJ, Stroink H, Oranje AP, et al. Endocrinologic disorders and optic pathway gliomas in children with neurofibromatosis type I. Pediatrics 1997;100:667–670.
• 8. Judge DM, Kulin HE, Santen R, Page R, Trabucki S. Hypothalamic hamartoma: a source of luteinizing hormone-releasing hormone factor in precocious puberty. N Engl J Med 1977;296:7–10.
• 9. Fetell MR, Stein BM. Neuroendocrine aspects of pineal tumors. Neurol Clin 1986;4:877-905.
• 10. Dickerman RD, Stevens QE, Steide JA, Schneider SJ. Precocious puberty associated with a pineal cyst: is it disinhibition of the hypothalamic-pituitary axis? Neuro Endocrinol Lett 2004;25:173-175.
• 11. Benítez Fuentes R, Velázquez de Cuéllar, Paracchi M, Blanco Rodríguez M, Soriano Guillén L. Central precocious puberty and pineal gland cyst: an association or incidental finding? Ann Pediatr (Barc) 2008;68:72-73.
• 12. Kumar KV, Verma A, Modi KD, Rayudu BR. Precocious puberty and pineal cyst: an uncommon association. Indian Pediatr 2010;47:193-194.
• 13. Ramaley JA, Bunn EL. Seasonal variations in the onset of puberty in rats. Endocrinology 1972;91:611-613.
• 14. Aubert ML, Rivest RW, Lang U, Winiger BP, Sizonenko PC. Delayed sexual maturation induced by daily melatonin administration eliminates the LH response to naloxone despite normal responsiveness to GnRH in juvenile male rats. Neuroendocrinology 1988;48:72-80.
• 15. Buchanan KL, Yellon SM. Delayed puberty in the male Djungarian hamster: effect of short photoperiod or melatonin treatment on the GnRH neuronal system. Neuroendocrinology 1991;54:96-102.
• 16. Wishoff JH, Epstein F. Surgical management of symptomatic pineal cysts. J Neurosurg 1992;77: 896-900.
• 17. Macchi MM, Bruce JN. Human pineal physiology and functional significance of melatonin. Front Neuroendocrinol 2004;25:177-195.
• 18. Aleandri V, Spina V, Morini A. The pineal gland and reproduction. Hum Reprod Update 1996;2:225-235.
• 19. Lacroix-Boudhrioua V, Linglart A, Ancel PY, Falip C, Bougnères PF, Adamsbaum C. Pineal cysts in children. Insights Imaging 2011;2:671-678.
• 20. Choy W, Kim W, Spasic M, Voth B, Yew A, Yang I. Pineal cyst: a review of clinical and radiological features. Neurosurg Clin N Am 2011;22:341-351.
• 21. Al-Holou WN, Garton HJL, Muraszko KM, Ibrahim M, Maher CO. Prevalence of pineal cysts in children and young adults. Clinical article. J Neurosurg Pediatr 2009;4:230-236.
• 22. Whitehead MT, Oh CO, Choudhri AF. Incidental pineal cysts in children who undergo 3-T MRI. Pediatr Radiol 2013;43:1577-1583.
• 23. Sizonenko PC. Physiology of puberty. J Endocrinol Invest 1989;12:59-63.
• 24. Seifert CL, Woeller A, Valet M, Zimmer C, Berthele A, Tölle T, et al. Headaches and pineal cyst: a case-control study. Headache 2008;48:448-452.
• 25. Ciraci S, Kalın S, Genç HM, Kutlubay B, Oysu A, Bükte Y. Evaluation of the relationship between pineal cyst and childhood headache with MR Imaging. Neurology Asia 2021;26:113-116.
• 26. Waldenlind E, Gustafsson SA, Ekbom K, Wetterberg L. Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission. J Neurol Neurosurg Psychiatry 1987;50:207-213.
• 27. Claustrat B, Loisy C, Brun J, Beorchia S, Arnaud JL, Chazot G. Nocturnal plasma melatonin levels in migraine: A preliminary report. Headache 1989;29:242-245.
• 28. Alehan FK. Value of neuroimaging in the evaluation of neurologically normal children with recurrent headache. J Child Neurol 2002;17:807-809.
• 29. Holanda FS, Tufik S, Bignotto M, Maganhin CG, Vieira LH, Baracat EC, et al. Evaluation of melatonin on the precocious puberty: a pilot study. Gynecol Endocrinol. 2011;27:519-523.