HYPOTHALAMIC HAMARTOMA UNVEILED BY CENTRAL PRECOCIOUS PUBERTY: A CASE REPORT

Abstract

Introduction:
Hypothalamic hamartoma (HH) is a rare congenital malformation associated mainly with central precocious puberty (CPP) and gelastic seizures, often leading to progressive neurocognitive and behavioral issues. Early diagnosis facilitates timely treatment and improved outcomes.

Case Presentation:
We describe a 2-year-3-month-old female child from Kanchipuram, India, presenting with recurrent vaginal bleeding for one year, breast budding for 8 months, and sparse pubic and axillary hair for 5 months. She demonstrated accelerated growth and significant advancement of bone age. Hormonal assays indicated elevated luteinizing hormone and estradiol levels. MRI showed a well-defined hypothalamic hamartoma located in the suprasellar region. The patient was started on monthly intramuscular leuprolide acetate (a GnRH analogue) and managed for iron deficiency anemia.

Conclusion:
This case emphasizes the importance of considering a central cause like hypothalamic hamartoma in early-onset puberty and reinforces the role of MRI for diagnosis and GnRH analogue therapy to halt pubertal progression, optimize final adult height, and improve psychosocial outcomes.