A three-year-old boy in India has undergone brain surgery to cure premature puberty, which made his genitals grow, deepened the timbre of his voice and caused acne to sprout on his face.
The boy was just 18 months old when his parents noticed the physical changes that normally start to develop in a boy at least a decade later. His behaviour had also become aggressive.
He was taken to the Jawaharlal Institute of Postgraduate Medical Education and Research (Jipmer) in Puducherry, where doctors found that he had excessive sex hormones.
More tests revealed that he was suffering from precocious puberty, a condition that affects one in every 5,000 to 10,000 children in the US, although its onset at such a young age is much rarer.
Precocious puberty occurs because of an abnormal production of oestrogen. It is often caused by damage to the brain or cerebral disorders.
It is more common in girls than boys and resulted in the youngest mother on record, Lina Medina, who gave birth at the age of five years and seven months in Peru in 1939.
Doctors at Jipmer found that the boy had abnormal tissue in the hypothalamus, an area of the brain linked to the nervous system that regulates hormones.
For two years, he had been treated with injections to stop the excessive secretion of hormones but there was little change in his condition and his parents could no longer afford to keep up with the payments. He would have had to have been on medication for 10 years.
As an alternative, doctors opted for rare skull base surgery and removed the abnormal tissue from the hypothalamus during the three-hour procedure.
V R Roopesh Kumar, head of neurosurgery at Jipmer, told the Times of India: "Precocious puberty can be completely cured by appropriate medical or surgical intervention if diagnosed early. Children with this condition attain puberty before eight years of age.
"The patient responded well. It is a complex surgery as the abnormal tissue had to be removed without damaging the vital neurovascular structures surrounding it.
"His hormone values became normal for his age and he does not require any further treatment."