Board Review 3 – Case 6
Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.
More description and the answer (spoiler!) are seen below the video.
This case shows a young adult who underwent precocious puberty. There is an expansile, non-enhancing mass in the region of the hypothalamus/tuber cinereum.
The diagnosis is: hypothalamic hamartoma
Hypothalamic hamartomas are disorderly (hamartomatous) collections of neurons in the hypothalamic/suprasellar region. They most commonly occur just behind the optic chiasm and pitutitary infundibulum. Many times, they will present with unusual symptoms like early puberty (most common) or seizure (even with uncommon seizures like laughing “gelastic” seizures or crying seizure).
The differential diagnosis for masses in this region include astrocytoma, craniopharyngioma, and germinoma. The most common overall mass in this region is craniopharygioma, but these commonly enhance avidly, have a mix of solid and cystic regions, and can calcify.