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Gamma Knife radiosurgery for hypothalamic hamartoma preserves endocrine functions
Author(s) -
Castinetti Frederic,
Brue Thierry,
Morange Isabelle,
Carron Romain,
Régis Jean
Publication year - 2017
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13760
Subject(s) - medicine , hypothalamic hamartoma , radiosurgery , hamartoma , endocrine system , hypothalamic disease , body mass index , precocious puberty , luteinizing hormone , hormone , endocrinology , pathology , radiation therapy , hypogonadotropic hypogonadism
Summary Gamma Knife radiosurgery (GK) is an effective treatment for hypothalamic hamartoma. No precise data are available on the risk of endocrine side effects of this treatment. In this study, 34 patients with hypothalamic hamartoma (HH) were followed prospectively at the Department of Endocrinology, La Timone Hospital, Marseille, France, for a mean follow‐up of >2 years (mean ± standard deviation [SD] 3.6 ± 2 years). Initial pre‐ and post‐GK radiosurgery evaluations were performed, including weight, body mass index (BMI), and a complete endocrinological workup. At diagnosis, eight patients presented with central precocious puberty at a mean age of 5.4 ± 2.4 years. At the time of GK (mean age 18.2 ± 11.1 years), two patients previously treated with surgery presented with luteinizing hormone/follicle‐stimulating hormone (LH/FSH) deficiency. After GK, only one patient presented with a new thyrotropin‐stimulating hormone (TSH) deficiency, 2 years after the procedure. The other pituitary axes remained normal in all but two patients (who had LH/FSH deficiency prior to GK). There was no significant difference between pre‐ and post‐GK mean BMI (26.9 vs. 25.1 kg/m 2 , p = 0.59). To conclude, in this group of 34 patients, GK did not induce major endocrinologic side effects reported with all the other surgical techniques in the literature. It is, thus, a safe and effective procedure in the treatment of hypothalamic hamartoma.