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Hypothalamic hamartoma causing precocious puberty treated by surgery: case report
B Romner1, J H Trumpy, G Marhaug
1Department of Neurosurgery, University Hospital of Tromsø, Norway.
Insights
A hypothalamic hamartoma caused precocious puberty in a young girl. Surgical removal of the tumor resolved her symptoms, demonstrating the effectiveness of this treatment for this rare condition.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Oncology
Background:
- Precocious puberty is characterized by early onset of secondary sexual characteristics.
- Hypothalamic hamartomas are rare, congenital tumors that can cause central precocious puberty.
- Early diagnosis and intervention are crucial for managing precocious puberty.
Observation:
- A 6-year-old girl presented with precocious puberty, including pubic hair and menses, since infancy.
- Initial computed tomography scans were normal.
- Magnetic resonance imaging revealed a pedunculated isodense mass below the tuber cinereum.
Findings:
- The patient underwent successful microsurgical resection of the hypothalamic hamartoma.
- Post-operatively, all signs and symptoms of precocious puberty resolved.
- One-year follow-up MRI confirmed complete tumor removal with no recurrence.
Implications:
- Surgical resection of hypothalamic hamartomas is an effective treatment for secondary precocious puberty.
- MRI is essential for diagnosing hypothalamic hamartomas when CT is inconclusive.
- Timely surgical intervention can normalize pubertal development and prevent long-term complications.
Abstract:
A 6-year-old girl was treated for precocious puberty secondary to a hypothalamic hamartoma by resection of the tumor. When she was six months old, her parents noticed incipient pubic hair and menses accompanied by breast development. Computed tomography was judged as normal. The girl was treated with monthly gonadotropin-releasing hormone analogue injections until 6 years of age, when magnetic resonance imaging (MRI) demonstrated a pedunculated isodense mass below the tuber cinereum. The hamartoma was totally removed using microsurgery. The symptoms and signs of precocious puberty disappeared after surgery. Follow-up MRI 1 year later showed no remaining tumor.