Hypothalamic Hamartoma: A Rare Cause of Precocious Puberty

Aims

To highlight the characteristic magnetic resonance imaging (MRI) features of hypothalamic hamartoma and its role in the diagnosis of central precocious puberty in children. Presentation of Case: A 9-year-old girl presented with progressive breast development, pubic hair growth, and accelerated linear growth. Clinical examination revealed Tanner stage IV development. Hormonal assessment showed elevated luteinizing hormone (0.92 IU/L) and estradiol (25 pg/mL), with normal follicle-stimulating hormone and 17-hydroxyprogesterone levels. Brain MRI demonstrated a small, well-circumscribed, non-enhancing lesion arising from the tuber cinereum, with signal intensity similar to grey matter and no mass effect on the optic chiasm or third ventricle. These findings were consistent with a hypothalamic hamartoma. The patient was treated with leuprorelin acetate, with favourable clinical and psychological evolution.