Suprasellar arachnoid cyst with precocious puberty

A 9-year-old boy with precocious puberty was presented with severe headache and vomiting, despite having a functioning ventriculoperitoneal shunt, from the age of one year for hydrocephalus. Magnetic resonance imaging revealed a tense suprasellar arachnoid cyst indenting the third ventricle. Decompression of cyst improved his headache and the features of precocious puberty at follow-up. His hormonal levels were not abnormal on gross neuroendocrine evaluation. It was concluded that suprasellar arachnoid cyst may manifest with features similar to raised intracranial pressure despite having a functioning shunt for associated hydrocephalus. Precocious puberty in such children may manifest without gross endocrinological abnormalities.