Sunday 23 March 2014

Hypothalamic Hamartoma presenting with precocious puberty

A 11 month old female child with bleeding per vagina.
Precocious puberty as per endocrinologist, advised MRI Brain for Pituitary.
MRI brain shows a supra sellar solid well defined lesion.
Pituitary seen separately in hypophyseal fossa. Normal enhancing pituitaty stalk seen separately and immediately anterior to lesion.
Lesion is iso intense to cortical gray matter on T1 as well as T2 w images, no cystic component. No enhancement on post contrast T1.
Lesion is in mid line, in the region of tuber cinerium and appears to be protruding from hypothalamus.

Imaging wise diagnosis: Hypothalamic Hamartoma.

Discussion: Hypothalamic Hamartoma supports clinical finding of Precocious Puberty though age is unusual but presentation with Precocious Puberty at 1 year of age is known and is well mentioned in literatures.

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