Patient's question:
The child was hospitalized yesterday for a thorough examination. The examination results revealed true precocious puberty and breast development. Regarding bone age, there were differing opinions: some said it was eight years old, while others said it was six years old. An MRI was performed, which showed a reduction in the hypothalamus-pituitary gland. Upon further review of the images, it was diagnosed as a hamartoma. Subsequently, another MRI was conducted, confirming the diagnosis of hypothalamic hamartoma.What assistance is needed: If the diagnosis is a hypothalamic hamartoma, what treatment should be administered?
Doctor's answer:
Hypothalamic hamartoma, which can be surgically treated, often alleviates clinical symptoms. The surgery is performed via the transcavernous approach, with attention paid to protecting the pituitary stalk and oculomotor nerve during the procedure to prevent internal carotid artery spasm. Postoperatively, attention should be paid to maintaining water and electrolyte balance in children and promptly correcting diabetes insipidus. With advancements in imaging and the development of microsurgical techniques, the complete resection rate of hypothalamic hamartomas has significantly increased, yielding good outcomes. After complete resection of the hamartoma, precocious puberty symptoms cease, and hormone levels return to normal. In some children, epilepsy attacks may completely stop or the frequency of recurrence may significantly increase.