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  #1  
Old 04-28-2012
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Wink Child with early puberty and laughter..!!!

A 9-year-old girl presents with precocious puberty and episodes of uncontrollable laughter. Which of the following mass lesions might explain her symptoms?


a. Craniopharyngioma
b. Choroid plexus papilloma
c. Giant aneurysm
d. Metastatic carcinoma
e. Hypothalamic hamartoma
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Old 04-28-2012
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Answer is A ............
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Old 04-28-2012
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Answer is E also known as "tuber cinerium hemartoma" it explains both the laugh and the precocious puberty.

Craniopharyngioma wont cause precocious puberty but rather will cause delayed development as it can cause decrease in LH FSH and their friends.

The other answers dont fit aswell.

seems a difficult question where do you guys get them from?
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Old 04-28-2012
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i will go with e
simply cause i believe that is the only one which can inc production of sexual hormones
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Old 04-28-2012
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I have no idea what would cause the uncontrollable laughter. But if I had to guess, I was gonna go with E. Simply because a hypothalamic hamartoma would suppress on the hypothalamus releasing more GnRH (precocious puberty) and cause some sort of anomaly in the Papez circuit of the Limbic system (uncontrollable laughter) ??
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Quote:
Originally Posted by Hope2Pass View Post
I have no idea what would cause the uncontrollable laughter.
what about early puberty
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Old 04-29-2012
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Default Answer is E

Hypothalamic hamartomas are nonneoplastic malformations involving neurons and glia in the region of the hypothalamus. They may be discovered incidentally, either on imaging performed for other reasons or at autopsy, or they may cause symptoms referable to the hypothalamus. Most often, the latter involves neuroendocrine functions, causing precocious puberty or acromegaly due to overproduction of growth hormone–releasing hormone. Patients may also experience paroxysms of laughter, known as gelastic seizures. They may be cured surgically.

Craniopharyngiomas cause hypopituitarism and visual field defects.
The rest options are not expected to cause these symptoms.
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Old 04-29-2012
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Quote:
Originally Posted by anomali View Post
Hypothalamic hamartomas are nonneoplastic malformations involving neurons and glia in the region of the hypothalamus. They may be discovered incidentally, either on imaging performed for other reasons or at autopsy, or they may cause symptoms referable to the hypothalamus. Most often, the latter involves neuroendocrine functions, causing precocious puberty or acromegaly due to overproduction of growth hormone–releasing hormone. Patients may also experience paroxysms of laughter, known as gelastic seizures. They may be cured surgically.

Craniopharyngiomas cause hypopituitarism and visual field defects.
The rest options are not expected to cause these symptoms.
E is correct, check goljan page476, endocrine chapter: "MCC of true precocious puberty is a midline hamatoma in hypothalamus"
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Quote:
Originally Posted by sol1411 View Post
E is correct, check goljan page476, endocrine chapter: "MCC of true precocious puberty is a midline hamatoma in hypothalamus"
your point is ?
he said the same thing .
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reference source though...in case you guys want to check where the infos come from
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Old 09-14-2012
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Hypothalamic hamartoma is correct.
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