A case of hypothalamic hamartoma associated with arachnoid cyst

Goda, Makoto; Tashima, Atsushi; Isono, Mitsuo; Hori, Shigeaki; Kimba, Yoshihira

doi:10.1007/s003810050446

Cited by 19 publications

(15 citation statements)

References 3 publications

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“…Mostly sporadic, a few of its cases (10%) have been reported in association with malformation syndromes like that of Pallister-Hall, McKusick-Kaufman, and Bardet-Biedl [2,4]. Amongst its reported lesional, intracranial associations are Rathke’s cleft cyst [4] and arachnoid cysts, either in the suprasellar region [5] or in the temporo-sylvian region [6,7,8]. Adding to this small list is our report of a suprasellar teratoma.…”

Section: Discussionmentioning

confidence: 99%

“…Our report discusses a hitherto undescribed synchronous association of this lesion with a teratoma, another congenital lesion with a predilection for the suprasellar region [9,10]. Such an occurrence helps in clarifying its dysontogenetic pathogenesis [4,5,6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

“…There have been anecdotal reports of its association with other congenital lesions like Rathke’s cleft cyst [4] and arachnoid cysts in the suprasellar [5] and temporo-sylvian [6,7,8] regions. Our report discusses a hitherto undescribed synchronous association of this lesion with a teratoma, another congenital lesion with a predilection for the suprasellar region [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Synchronous Occurrence of a Hemorrhagic Hypothalamic Hamartoma and a Suprasellar Teratoma

Kiran

Ghosal²,

Thakar³

et al. 2011

Pediatr Neurosurg

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Hypothalamic hamartomas have been reported to coexist with lesions like Rathke’s cleft cyst and arachnoid cysts in the suprasellar or temporo-sylvian regions. This is the first report in indexed literature describing its association with a suprasellar teratoma. A 7-year-old girl presented with long-standing precocious puberty and generalized tonic-clonic seizures and recent-onset raised intracranial pressure. MRI done prior to the onset of symptomatic raised intracranial pressure revealed 2 distinct lesions in the suprasellar region. One was a midline, pedunculated lesion arising from the hypothalamus, with evidence of an old bleed within it. A separate lesion, with a wide base near the tuberculum sellae and a posteriorly directed conical tip, was noted in an adjacent sagittal cut. CT scan done at the time of admission demonstrated a re-bleed in the suprasellar region with blood in the lateral and third ventricles and gross hydrocephalus. The child was taken up for a ventriculoperitoneal shunt followed by complete excision of the lesions. Histopathologic examination confirmed the pedunculated lesion to be a hypothalamic hamartoma with evidence of hemorrhage, and the other to be a mature teratoma. Postoperative MRI confirmed complete excision of both the lesions. The child reported regression of precocious puberty and remained seizure-free until the last follow-up 6 months after surgery. A hypothesis based on a dysontogenetic mechanism is discussed to explain the unusual occurrence of the dual, seemingly unrelated pathologies. Hemorrhage into the hamartoma was an added oddity in this case.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Synchronous Occurrence of a Hemorrhagic Hypothalamic Hamartoma and a Suprasellar Teratoma

Kiran

Ghosal²,

Thakar³

et al. 2011

Pediatr Neurosurg

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“…Arachnoid cysts are most common in children. 8 Resolution of both symptomatic and asymptomatic cysts over time may explain the decline in their number with age. association between middle fossa cysts and subdural hematomas has been reported.…”

Section: Discussionmentioning

confidence: 99%

Arachnoid cysts: spontaneous resolution distinct from traumatic rupture

Bristol¹,

Albuquerque²,

McDougall³

et al. 2007

FOC

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✓Although many arachnoid cysts are discovered incidentally and require no intervention, a small subset has been known to rupture. Note that rupture can occur either spontaneously or in association with trauma. Based on a review of the literature on ruptured arachnoid cysts, it appears that patients with middle fossa cysts are more likely to experience symptomatic traumatic rupture than those with cysts in other locations. Middle fossa cysts are more commonly associated with hemispheric subdural collections and hematomas than are any other cysts. The authors report on two representative cases illustrating the distinct presentation, imaging characteristics, and management of these cysts.

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“…41 Surprisingly, there are anecdotal case reports on HHs associated with arachnoid cysts. 17,23,31,36 Hence, it is important to distinguish a suprasellar arachnoid cyst from a cystic HH.…”

Section: Cystic Changes In Hhmentioning

confidence: 99%

Hypothalamic hamartoma simulating a suprasellar arachnoid cyst: resolution of precocious puberty following microsurgical lesion resection

Manjila

Vogel

Chen

et al. 2014

PED

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Hypothalamic hamartomas (HHs) are rare developmental lesions arising from the inferior hypothalamus that may cause gelastic seizures and central precocious puberty. Cystic changes in HHs are rare, usually occurring in giant lesions. The authors describe an unusual case of cystic HH masquerading as a suprasellar arachnoid cyst in an 18-month-old girl presenting with precocious puberty. Microsurgical removal of the lesion led to complete resolution of the precocious puberty on long-term follow-up. This case is the first reported HH with pathological demonstration of corticotropin-releasing hormone immunostaining in the solid tumor and glial cells in the cyst wall of the lesion. The clinical and radiological characteristics of HHs are reviewed, along with the unique surgical strategies used to manage cystic lesions in the suprasellar region.

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A case of hypothalamic hamartoma associated with arachnoid cyst

Cited by 19 publications

References 3 publications

Synchronous Occurrence of a Hemorrhagic Hypothalamic Hamartoma and a Suprasellar Teratoma

Synchronous Occurrence of a Hemorrhagic Hypothalamic Hamartoma and a Suprasellar Teratoma

Arachnoid cysts: spontaneous resolution distinct from traumatic rupture

Hypothalamic hamartoma simulating a suprasellar arachnoid cyst: resolution of precocious puberty following microsurgical lesion resection

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