Precocious Puberty: Etiology and Current Treatment

Precocious puberty also known as premature puberty is an abnormal pubertal development that can affect a child's growth and development. The clinical manifestations of precocious puberty are generally diverse and based on etiology are classified into central precocious puberty (GnRH dependent) and peripheral precocious puberty (GnRH independent). The main concern with precocious puberty is that precocious puberty can be a clinical symptom of an underlying serious disease such as a brain tumor, adrenal or gonadal tumor and others. Early identification of etiology plays an important role in prevention, diagnosis, and treatment of this disease. This literature review aims to determine the etiology and current management of precocious puberty. This literature review uses the keywords "Precocious Puberty AND etiology AND treatment" through the National Center for Biotechnology Information (NCBI) and Google Scholar databases. This article uses 11 articles that were used as references in its preparation. In conclusion, it is necessary to know the etiology of precocious puberty using imaging examinations for optimal management and excluding malignant abnormalities. The current treatment for central precocious puberty is GnRH agonists (gold-standard) and surgery in cases of intracranial lesions and peripheral precocious puberty using a combination of androgen antagonists (spironolactone) and aromatase inhibitors (anastrozole, testolactone) and surgery is indicated for gonadal and adrenal tumors. The role of parents is very important in early detection of precocious puberty, because the earlier the therapy, the better the prognosis

Giant Cell Tumor: Pathogenesis and Clinical Manifestation

A giant cell tumor of bone (GCTB) as known as a benign bone tumor (neoplasm) is aggressive locally and frequently recurs, and it is characterized by the growth of mononuclear stromal cells and datia cells that resemble osteoclasts. GCTB has varying incidence rates and has been shown to have high mortality. GCTB patients have several treatment options, but the majority of patients still experience recurrence and even metastasis to other organs. This literature review aims to explain more deeply about Giant Cell Tumor (GCT) starting from the definition, etiology, epidemiology, pathogenesis, clinical manifestations and treatment options so that patients get a better prognosis. This literature review was conducted using the keywords "Giant Cell Tumor AND pathogenesis AND clinical manifestation" from PubMed dan Google Scholar. The results of the literature review carried out are that the molecular and biological pathogenesis of GCTB consists of 4 processes, namely tumorigenesis of neoplastic mononuclear stromal cells, generation of reactive multinucleated giant cells, bone resorption/migration, and bone matrix remodeling for angiogenesis, invasiveness, and metastasis. Besides, the histological picture of GCTB contains "reactive" osteoclasts such as multinucleated giant cells (Giant Cells/GC), round cells such as macrophages and spindle stromal cells such as "neoplastic" fibroblasts (mononuclear stromal cells/SC) which are important findings in establishing the diagnosis. In conclusion, staging and management are very important to produce a better prognosis and reduce recurrence rates in GCTB patients