A systematic review of stereotactic radiofrequency ablation for hypothalamic hamartomas

Kondajji, Aditya; Evans, Audree; Lum, Meachelle; Kulinich, Daniel; Unterberger, Ansley; Ding, Kevin; Duong, Courtney; Patel, Kunal; Yang, Isaac

doi:10.1016/j.jns.2021.117428

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…With these techniques, it is theoretically feasible to take minimally invasive surgery one step further in terms of reducing recovery time, pain, and scarring in patients. Although nowadays these emerging techniques have been widely used in the treatment of benign and malignant tumors, complete assessments of their safety and e cacy are still limited [9,17]. Therefore, in this present study, we shared our experience and further evaluate the e cacy and safety.…”

Section: Discussionmentioning

confidence: 90%

Efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes from papillary thyroid carcinoma

Zhang,

Liu,

Zhou

et al. 2024

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OBJECTIVE: To evaluate the efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes (LNs) from papillary thyroid carcinoma (PTC). MATERIALS AND METHODS: A total of 77 patients with 79 LNs ablated by microwave ablation (MWA) or radiofrequency ablation (RFA) between September 2018 and October 2022 were enrolled in this study. After treatment, patients were followed up with measurement of diameters of LNs and serum thyroglobulin (s-Tg) at 1, 3, 6, and 12 months and annually thereafter. The paired t-test was used to compare the changes of s-Tg level, diameters of LNs before and after ablation. RESULTS: There were no serious complications related to ablation while one case of incomplete ablation in MWA was found during follow-up. The mean longest and shortest diameter of the ablated LNs reduced from 11.6 ± 4.3 mm to 5.0 ± 4.1 mm (p < 0.001), and from 6.1 ± 1.9 mm to 3.0 ± 2.5 mm (p < 0.001) at the last follow-up visit. Besides, the final volume reduction rate (VRR) was 61.8 ± 56.4% (range, –67.0 –100%). The complete disappearance rate was 46.8%, but there were 4 (5.1%) LNs becoming bigger than before. The average s-Tg level was 9.2 ± 26.6 ng/mL, a data significantly decreased to 3.7 ± 7.0 ng/mL at the last follow-up, but no statistical difference was shown. CONCLUSION: Thermal ablation is an effective and safe modality for the treatment of metastatic LNs from PTC.

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Section: Discussionmentioning

confidence: 90%

Efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes from papillary thyroid carcinoma

Zhang,

Liu,

Zhou

et al. 2024

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“…Although HH does not grow after birth, remarkable obesity frequently appears [ 12 ]. Under hypothalamic dysfunction, rapid weight gain due to decreased energy expenditure and increased energy storage in adipose cells can occur from combinations of a reduction in metabolic rate, increased vagal tone, hyperinsulinism with leptin resistance, or sleep disturbance, irrespective of the patient's age [ 8 , 13-16 ]. Previous studies have reported that girls with CPP accompanied by HH exhibited a higher body mass index than those with idiopathic CPP [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there is no specific therapeutic approach for children with HO [ 14 ]. Surgical treatment for HH is not recommended because it can cause irreversible damage to the hypothalamus [ 8 ]. However, Esquenazi et al [ 22 ] reported that a 10-year-old girl with HH and CPP who had refractory overeating and weight gain underwent surgical resection, which resulted in reduced weight gain.…”

Section: Discussionmentioning

confidence: 99%

“…Hypothalamic obesity (HO) is also common in patients with HH, with an occurrence rate of approximately 20% to 36% [ 3 , 4 ], but symptomatic HH associated with obesity is seldom discovered [ 5-7 ]. HO is usually diagnosed either at the initial diagnosis of neurological or endocrine disorders or during treatment [ 8 ]. To our knowledge, there have been no reported cases of obesity solely attributed to HH in infancy.…”

Section: Introductionmentioning

confidence: 99%

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Infantile Hypothalamic Hamartoma: A Rare Presentation of Isolated Obesity

Tsumori,

Itonaga,

Oyake

et al. 2024

JCEM Case Reports

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Hypothalamic hamartomas (HHs) are rare, benign brain tumors or lesions of the hypothalamus that are predominantly identified in cases of epilepsy and central precocious puberty (CPP), whereas isolated manifestations of infantile obesity are atypical. We herein report an 8-month-old boy with severe obesity (Kaup index 26.4 [>100th percentile]) and uncontrollable hyperphagia. His growth chart demonstrated remarkable weight gain that exceeded the length gain in magnitude. Brain magnetic resonance imaging identified a lesion consistent with HH. There were no episodes or clinical findings of epilepsy, CPP, or Cushing disease. Hypothalamic obesity should be considered in the diagnosis even in infants with excessive weight gain due to overeating.

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“…6 Among the seizure types, gelastic attacks are the most common and associate explicitly with HH; these seizures are defined by inappropriate laughing and are often resistant to antiepileptic agents. 1 Gelastic and dacrystic (associated with a crying sound and less common than gelastic) seizures 7 are the primary seizure types in patients with an HH, and their onset usually occurs in the 1st year of life. Still, these seizures are not diagnosed until the patient develops other seizure types, which are probably a consequence of secondary epileptogenesis involving temporal and frontal structures.…”

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confidence: 99%

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

Iranmehr

Ohadi

Chavoshi

et al. 2022

Neurosurgical Focus

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OBJECTIVE Hypothalamic hamartoma (HH) is a rare, nonmalignant, heterotopic developmental malformation that consists of a mixture of normal neurons and glial cells. Resection of HHs has been associated with high rates of mortality and morbidity. Therefore, minimally invasive ablation methods could be the best treatment option for HH. The most frequently used minimally invasive options for HH ablation are radiofrequency thermocoagulation (RFT), laser ablation (LA), and stereotactic radiosurgery. METHODS To investigate three minimally invasive procedures in the treatment of refractory seizures related to HH, the authors conducted a systematic search in March 2022 in the MEDLINE, Embase, Scopus, and Web of Science databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seizure freedom was the primary outcome of interest. The authors defined seizure freedom as Engel class I or International League Against Epilepsy class 1 or 2 or as the reported term “seizure freedom.” The secondary outcome was long-term complications reported in studies. Both random- and fixed-effects models were used to calculate the pooled proportion of seizure freedom and complication rate with 95% confidence intervals. A modified version of the Joanna Briggs Institute (JBI) Critical Appraisal to assess the risk of bias was used. RESULTS The authors included 15 studies with 422 patients (RFT, n = 190; LA, n = 171; and Gamma Knife Radiosurgery [GKRS], n = 61). Generally, the mean incidences of overall seizure freedom after minimally invasive procedures were 77% (95% CI 0.74–0.81) and 68% (95% CI 0.57–0.79) using fixed- and random-effects models, respectively. The mean incidence of overall seizure freedom after RFT was 69% (95% CI 0.63–0.75), and the mean incidences of overall seizure freedom after LA and GKRS were 87% (95% CI 0.82–0.92) and 44% (95% CI 0.32–0.57), respectively. The total complication rate with minimally invasive procedures was 13% (95% CI 0.01–0.26). The complication rate in each treatment was as follows: 5% (95% CI 0.0–0.12) for RFT, 20% (95% CI 0.0–0.47) for LA, and 22% (95% CI 0–0.65) for GKRS. Meta-regression analysis showed an association between older age and higher complication rates in the LA group. CONCLUSIONS In this meta-analysis, LA showed superiority in seizure freedom over the other two methods. The complication rate associated with RFT was less than those in the other two methods; however, this difference was not statistically significant.

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A systematic review of stereotactic radiofrequency ablation for hypothalamic hamartomas

Cited by 7 publications

References 24 publications

Efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes from papillary thyroid carcinoma

Efficacy and safety of percutaneous ultrasound-guided thermal ablation in the treatment of cervical metastatic lymph nodes from papillary thyroid carcinoma

Infantile Hypothalamic Hamartoma: A Rare Presentation of Isolated Obesity

Minimally invasive procedures for hypothalamic hamartoma–related epilepsy: a systematic review and meta-analysis

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