Defined by the presence of virilizing signs in girls. Select the type of sexual precocity with which it is most likely to be associated (SELECT 1 PRECOCITY)

True sexual precocity in girls is characterized by normal gonadotropin levels (as opposed to expected low prepubertal gonadotropin levels) and a normal ovulatory pattern. It represents premature activation of a normally operating hypothalamic-pituitary axis. Although it is usually idiopathic, true sexual precocity can arise from cerebral causes such as tumors or a history of encephalitis or meningitis, as well as from hypothyroidism, polyostotic fibrous dysplasia, neurofibromatosis, and other disorders. In girls who have precocious pseudo puberty, the endocrine glands, usually under neoplastic influences, produce elevated amounts of estrogens (isosexual precocious pseudo puberty) or androgens (heterosexual precocious pseudo puberty). Ovarian tumors appear to be the most common cause of isosexual precocious pseudo puberty; some ovarian tumors, including dysgerminomas and choriocarcinomas, can produce so much gonadotropin that pregnancy tests are positive. Incomplete sexual precocity, which is usually idiopathic, is characterized by only partial sexual maturity, such as premature thelarche or premature adrenarche (pubarche). Incomplete sexual precocity can be accompanied by abnormal function of the central nervous system (e.g., mental deficiency). Gonadotropin levels are frequently normal in these patients. In gonadotropin-producing tumors, high levels of gonadotropins such as FSH are produced with subsequent production of estrogen. Examples of these rare tumors are hepatoma, chorioepithelioma, and presacral tumors.