Is surgery effective for treating hypothalamic hamartoma causing isolated central precocious puberty? A systematic review

Agrawal, Mohit; Samala, Raghu; Doddamani, Ramesh; Goyal, Alpesh; Tripathi, Manjari; Chandra, P. Sarat

doi:10.1007/s10143-021-01512-6

Cited by 7 publications

(6 citation statements)

References 63 publications

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“…In boys, this tended to be associated with central nervous system abnormalities. It is the most common cause of neurogenic CPP 4 10–13…”

Section: Discussionmentioning

confidence: 99%

“…Establishing the correct aetiology of CPP is important to initiate prompt treatment and stop or revert the progression of secondary sexual characteristics. Treatment will reduce the psychological impact of advanced puberty on the child and family and prevent short stature associated with early epiphysial closure due to accelerated skeletal maturation 4 11–13…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, medical therapy is the mainstream of treatment for patients presenting with CPP as the sole manifestation 4…”

Section: Discussionmentioning

confidence: 99%

“…GS consists of uncontrollable mirthless laughter, which was often unrecognised in the early years 3. HH is one of the most common causes of non-idiopathic CPP 4. Although its pathophysiology is not completely understood, it can be managed using gonadotropin-releasing hormone agonists (GnRHa) 1 4.…”

Section: Introductionmentioning

confidence: 99%

“…HH is one of the most common causes of non-idiopathic CPP 4. Although its pathophysiology is not completely understood, it can be managed using gonadotropin-releasing hormone agonists (GnRHa) 1 4. We present a case of CPP in a girl in middle childhood in whom a complete aetiological investigation, including brain MRI scans, allowed for correct diagnosis of HH.…”

Section: Introductionmentioning

confidence: 99%

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Hypothalamic hamartoma: a cause of precocious puberty

Castro

Morais²,

Correia³

et al. 2023

BMJ Case Rep

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Hypothalamic hamartomas are uncommon congenital malformations that present as precocious puberty, gelastic seizures and/or psychiatric disorders. Characteristic changes in MRI scans lead to a diagnosis. Treatment may include surgery or gonadotropin-releasing hormone agonists (GnRHa) depending on clinical manifestations.Here, we describe a case of hypothalamic hamartoma diagnosed in a girl in middle childhood, who presented with early development of secondary sexual characteristics. Physical examination, hormonal study, bone age and pelvic ultrasound findings were consistent with those of precocious puberty. The investigation also included a brain MRI scan, which revealed a small nodule with regular limits in the left hypothalamic region/tuber cinereum. GnRHa treatment and neurosurgical follow-ups were initiated promptly. The patient showed a reversal of secondary sexual characteristics and stable hamartoma size. This case illustrates the importance of brain MRI scans as part of the assessment of suspected precocious puberty because clinical features do not identify patients with an underlying pathology.

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“…In boys, this tended to be associated with central nervous system abnormalities. It is the most common cause of neurogenic CPP 4 10–13…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…On the other hand, medical therapy is the mainstream of treatment for patients presenting with CPP as the sole manifestation 4…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hypothalamic hamartoma: a cause of precocious puberty

Castro

Morais²,

Correia³

et al. 2023

BMJ Case Rep

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Surgical and radiosurgical treatment of hypothalamic hamartoma: The Italian experience between 2011 and 2021

Rizzi,

Consales,

Tramacere

et al. 2024

Epilepsia Open

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ObjectiveTo investigate the Italian experience on the surgical and radiosurgical treatment of drug‐resistant epilepsy due to hypothalamic hamartoma (HH) in the period 2011–2021 in six Italian epilepsy surgery centers, and to compare safety and efficacy profiles of the different techniques.MethodsWe collected pseudo‐anonymized patient's data with at least 12 months of follow‐up. Surgical outcome was defined according to Engel classification of seizure outcome. Univariate analysis was performed to assess the risk of post‐operative seizures, categorized in dichotomous variable as favorable and unfavorable; explanatory variables were considered. Mann–Whitney or Chi‐squared test were used to assess the presence of an association between variables (p < 0.05).ResultsFull presurgical and postoperative data about 42 patients from 6 epilepsy surgery centers were gathered. Engel class I was reached in the 65.8% and 66.6% of patients with gelastic and non‐gelastic seizures, respectively. Other than daily non‐gelastic seizures were associated with seizure freedom (p = 0.01), and the radiological type presented a trend toward significance (p = 0.12).SignificanceEndoscopic disconnection and laser interstitial thermal therapy are effective in the treatment of HH‐related epilepsy, with a tolerable safety profile. Both gelastic and non‐gelastic seizures can be treated, also in patients with a long history of seizures.Plain Language SummaryThis study collected data about 42 patients with HH‐related epilepsies. Endoscopic disconnection and laser therapy are both effective and safe in the treatment of hypothalamic hamartoma‐related epilepsies.

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