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a

c

e

b

d

f

Fig. 6.7 (a) A 7-year-old boy with GIPP due to hCG secreting intracranial germinoma. (b) He did
not have gynecomastia. (c) External genitalia showing disproportionate penile enlargement in rela-
tion to testicular volume (bilateral testicular volume 4 ml). (d) Axial CT head showing isodense
lesion in the pineal region (red arrow) suggestive of germ cell tumor (e, f) Sagittal CEMR showing
heterogeneously enhancing mass in the pineal region in T1 image (red arrow) and hypointense on
T2 image (red arrow). Note the loss of scalp hair after chemotherapy

6 Precocious Puberty