Treatments of Hamartoma with Neuroendoscopic Surgery and Stereotactic Radiosurgery:A Case Report

Abstract

Hypothalamic hamartoma is a non-neoplastic tumor consisting of ectopic brain tissue derived from the hypothalamus [ 1 ]. Patients with hypothalamic hamartoma sometimes present with gelastic seizure, precocious puberty, and behavioral disorder [ 2 ] [ 3 ]. The neuroradiological diagnosis of hypothalamic hamartoma is based on the following criteria: an isointense lesion relative to normal gray matter on T₁-weighted magnetic resonance (MR) images, with pedunculated or sessile attachment to the hypothalamus; lack of contrast enhancement on MR images or computed tomographic scans; and absence of progress radiologically on repeated examinations [ 4 ]. We report a case of hypothalamic hamartoma with violent behavior, precocious puberty, and gelastic and atonic seizures. In this case, evolution of MR images with aggravation of symptoms was observed during follow-up. This patient was treated by neuroendoscopic surgery and linear accelerator (Linac) stereotactic radiosurgery (SRS). We discuss the treatments of hypothalamic hamartoma.