Sonography of autonomous follicular ovarian cysts in precocious pseudopuberty.

Isolated follicular cysts of the ovary without elevated gonadotropin levels can occur as the primary source of early pubertal changes in young girls. To date, cyst excision or oophorectomy have been the treatments of choice. We studied three girls aged 5 to 8 7/12 years who presented with sexual precocity and revealed autonomous functioning ovarian cysts (2.2 to 5.5 cm). Clinical signs subsided following resection of the cyst in one case and after regression of the cyst documented by ultrasonography in the other two cases. On the basis of these three cases, we believe ultrasonography can be valuable in the workup of sexual precocity caused by primary ovarian cysts. Given that the spontaneous resolution of such cysts is possible, close clinical follow-up of unequivocally benign-appearing large ovarian cysts in young girls with pubertal changes deserves consideration.