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Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
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Central precocious puberty in a toddler with hypothalamic hamartoma
Banu Turhan1, Gönül Büyükyılmaz1, Mehmet Boyraz1
1Pediatric Endocrinology Clinic, Bilkent City Hospital, Ankara, Türkiye.
Journal of Pediatric Endocrinology & Metabolism : JPEM
|December 22, 2024
Summary
Hypothalamic hamartoma (HH) can cause central precocious puberty (CPP) in young children. Early diagnosis and monitoring of HH-related CPP are crucial for effective management.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Radiology
Background:
- Hypothalamic hamartoma (HH) is a rare congenital brain malformation.
- HH can lead to epilepsy and central precocious puberty (CPP).
- Early identification of CPP in children under 4 is essential.
Observation:
- A 26-month-old girl presented with precocious puberty (Tanner stage 3, bone age 7y4m).
- Brain MRI revealed a hypothalamic hamartoma (11x9x10 mm).
- The patient received leuprolide acetate for CPP secondary to HH.
Findings:
- Treatment with gonadotropin-releasing hormone analogue stabilized pubertal progression.
- Breast development remained Tanner stage 3 over 2 years.
- Bone age advanced minimally (7y6m at chronological age 4y2m).
- HH size remained stable on follow-up MRI with no reported side effects.
Implications:
- HH should be considered in the differential diagnosis of CPP in children under 4 years.
- Close monitoring of patients with HH-related CPP undergoing medical treatment is recommended.
- This case highlights the efficacy of GnRH analogue therapy in managing HH-induced CPP.
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