Fact-sheet: Hamartoma of brain


Updated on 08/26/2020 at 4:13 PM

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Definition

Proliferation of normal neural tissue (gray matter) located in a heterotopic position.

They are located in the tuber cinereum, in the floor of the 3rd ventricle between the pituitary stalk and the mammillary bodies.

Clinical features

  • Precocious puberty
  • Seizures
  • Gelastic seizures (unprovoked laughter).
  • Dacrystic seizures (crying spells)

CT

  • Rounded, sessile or pedunculated, well-defined mass, isodense to gray matter, without contrast enhancement.
  • No mass effect.
  • Calcifications exceptional.

MRI

  • Rounded, sessile or pedunculated, well-defined mass
  • T1: isointense to brain parenchyma
  • T2: mild hyperintensity possible, depending on glial component.
  • After gadolinium injection: no enhancement
  • Spectroscopy: decreased NAA/Cr ratio and increased myo-inositol/Cr and Cho/Cr ratios

Management

  • Follow-up: stable, non-progressive lesion.
  • Endoscopic surgery or stereotactic radiosurgery depending on clinical impact

Differential diagnosis

  • Hypothalamic glioma --> T2 hyperintensity
  • Glioma should be suspected in case of enhancement after contrast administration.