Presentation
Central precociuous puberty
Patient Data
Solitary well delineated small pedunculated lesion arising from tuber cinereum projecting inferiorly into the suprasellar cistern. It is returning iso-intense signal to the grey matter on T1WI and T2WI without enhancement on post contrast study.
Case Discussion
Tuber cinereum hamartoma / hypothalamic hamartoma is a non-neoplastic heterotopic overgrowth of normal nervous tissue. It clinically manifests as precocious puberty, gelastic seizures, cognitive malfunction or epilepsy/ neurobehaviour disorder. It has two morphological types: sessile and pedunculated. It is made up of grey matter hence they have a similar imaging appearance of the cortex. A close differential diagnosis is a hypothalamic-chiasmatic glioma, which returns different signal intensity and exhibits post-contrast enhancement. Patients with central precocious puberty are treated medically, however, intractable seizures are subjected to surgery, stereotactic radiofrequency thermoablation or gamma knife radiosurgery.