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Microsurgical treatment for hypothalamic hamartoma in children with precocious puberty
Shiqi Luo1, Chunde Li, Zhenyu Ma
1Department of Neurosurgery, Beijing Tiantan Hospital, Beijing, China
Insights
Microsurgery effectively treated precocious puberty in children with hypothalamic hamartoma. All patients fully recovered, with symptoms resolving and hormone levels normalizing after surgical removal of the hamartoma.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Endocrine Surgery
Background:
- Precocious puberty can be caused by hypothalamic hamartoma, a rare brain tumor.
- This study reviews the surgical management of this condition.
Observation:
- Six children (3 boys, 3 girls) aged 13 months to 5 years presented with precocious puberty due to hypothalamic hamartoma.
- Symptoms included advanced physical development and elevated sexual hormone levels.
- MRI confirmed pedunculated hamartomas ranging from 4 to 12 mm.
Findings:
- All patients underwent complete surgical resection of the hamartoma via a right pterional approach.
- Post-surgery, all children experienced complete resolution of precocious puberty symptoms.
- Serum sexual hormone levels normalized to pre-pubertal ranges without complications.
Implications:
- Microsurgical treatment is highly effective for pedunculated hypothalamic hamartomas causing precocious puberty.
- Complete tumor removal leads to full recovery and normalization of development in affected children.
- This approach offers a safe and successful therapeutic option.
Background:
We review the surgical treatment of hypothalamic hamartoma causing precocious puberty.
Methods:
Six children (three girls and three boys) with precocious puberty secondary to hypothalamic hamartoma were recruited for our study. The mean age of the patients was 30 months old (range 13 months to 5 years), and the mean age of the onset of puberty was 7.3 months. All patients were treated by microsurgery.
Results:
All patients had higher then normal stature, body weight, bone growth, and serum levels of sexual hormones. The boys presented with mature external genitalia, pubic hair, frequent erection, and acne, while the girls presented with growth of breasts and menarche. Magnetic resonance image (MRI) revealed an isointense mass below the tuber cinereum extending into the supersellar and interpeduncular cistern, ranging from 4 to 12 mm in diameter, consistent with pedunculate hamartoma. The hamartoma was removed completely via a right pterional approach. The symptoms and signs of precocious puberty resolved completely, and sexual hormone levels decreased to the pre-pubertal range in all six patients without any postoperative complications.
Conclusion:
We report a series of six children with hypothalamic hamartoma-induced precocious puberty who underwent microsurgical treatment. All of them recovered completely to their age-appropriate state. Microsurgery is a good choice of treatment for pedunculate hypothalamic hamartoma.