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In vivo magnetic resonance spectroscopy for the differential diagnosis of a cerebral mass in a boy with precocious puberty: a case report and review of the literature.

التفاصيل البيبلوغرافية
العنوان: In vivo magnetic resonance spectroscopy for the differential diagnosis of a cerebral mass in a boy with precocious puberty: a case report and review of the literature.
المؤلفون: Kosteria I; Department of Endocrinology, Growth & Development, 'P&A Kyriakou' Children's Hospital, Athens, Greece. ikosteria@med.uoa.gr., Gavra MM; Department of Paediatric Radiology (CT, MRI) & Nuclear Medicine, Aghia Sophia Children's Hospital, Athens, Greece., Verganelakis DA; Nuclear Medicine Unit, Oncology Clinic 'Marianna V. Vardinoyiannis-ELPIDA', Aghia Sophia Children's Hospital, Athens, Greece., Dikaiakou E; Department of Endocrinology, Growth & Development, 'P&A Kyriakou' Children's Hospital, Athens, Greece., Vartzelis G; Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P&A Kyriakou' Children's Hospital, Athens, Greece., Vlachopapadopoulou EA; Department of Endocrinology, Growth & Development, 'P&A Kyriakou' Children's Hospital, Athens, Greece.
المصدر: Hormones (Athens, Greece) [Hormones (Athens)] 2023 Sep; Vol. 22 (3), pp. 507-513. Date of Electronic Publication: 2023 Jun 26.
نوع المنشور: Case Reports; Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Springer International Publishing Country of Publication: Switzerland NLM ID: 101142469 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2520-8721 (Electronic) Linking ISSN: 11093099 NLM ISO Abbreviation: Hormones (Athens) Subsets: MEDLINE
أسماء مطبوعة: Publication: <2018-> : [Cham] : Springer International Publishing
Original Publication: Athens, Greece : Hellenic Endocrine Society, [2002]-
مواضيع طبية MeSH: Hamartoma*/complications , Hamartoma*/diagnosis , Hypothalamic Diseases*/diagnosis , Puberty, Precocious*/diagnosis , Puberty, Precocious*/etiology, Child, Preschool ; Humans ; Male ; Diagnosis, Differential ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Seizures/complications ; Seizures/diagnosis
مستخلص: Purpose: To highlight the role of in vivo magnetic resonance spectroscopy (MRS) as a non-invasive tool that can clarify the etiology of sellar tumors by presenting the case of a boy with central precocious puberty (CPP) and to review the current literature.
Methods: A 4-year-old boy was admitted to our hospital due to repeated episodes of focal and gelastic seizures in the previous year. Clinical examination (testicular volume 4-5 ml bilaterally, penile length of 7.5 cm, and absence of axillary or pubic hair) and laboratory tests (FSH, LH, and testosterone) were indicative of CPP. The combination of gelastic seizures with CPP in a 4-year-old boy raised the suspicion of hypothalamic hamartoma (HH). Brain MRI revealed a lobular mass in the suprasellar-hypothalamic region. The differential diagnosis included glioma, HH, and craniopharyngioma. To further investigate the CNS mass, an in vivo brain MRS was performed.
Results: Οn conventional MRI, the mass demonstrated isointensity to gray matter on T1 weighted images but slight hyperintensity on T2-weighted images. It did not show restricted diffusion or contrast enhancement. On MRS, it showed reduced N-acetyl aspartate (NAA) and slightly elevated myoinositol (MI) compared with values in normal deep gray matter. The MRS spectrum, in combination with the conventional MRI findings, were consistent with the diagnosis of a HH.
Conclusion: MRS is a state-of-the-art, non-invasive imaging technique that compares the chemical composition of normal tissue to that of abnormal regions by juxtaposing the frequency of measured metabolites. MRS, in combination with clinical evaluation and classic MRI, can provide identification of CNS masses, thus eliminating the need for an invasive biopsy.
(© 2023. The Author(s), under exclusive licence to Hellenic Endocrine Society.)
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فهرسة مساهمة: Keywords: Central precocious puberty; Hypothalamic hamartoma; In vivo magnetic resonance spectroscopy
SCR Disease Name: Hypothalamic hamartomas
تواريخ الأحداث: Date Created: 20230626 Date Completed: 20230831 Latest Revision: 20230831
رمز التحديث: 20231215
DOI: 10.1007/s42000-023-00458-2
PMID: 37365434
قاعدة البيانات: MEDLINE
الوصف
تدمد:2520-8721
DOI:10.1007/s42000-023-00458-2