Giant Hypothalamic Hamartoma
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A 9-year-old girl was referred to our endocrinology service for short stature. She was otherwise well without a history of headaches or visual symptoms. She was a full-term baby with normal birth weight and no prenatal abnormalities. Upon endocrinologic evaluation, she was found to have central growth hormone deficiency and hypothyroidism. She was referred to radiology for a brain MRI to rule out a structural cause for her multiple endocrinopathies. MR imaging of the brain without and with contrast was performed and showed a large, slightly heterogeneous mass in the suprasellar region.The mass was isointense to the brain on the unenhanced T1- and T2-weighted images, without abnormal enhancement.The mass had a cerebriform appearance, resembling a 'brain-within-a-brain' architecture. There was associated mass effect on the optic chiasm, and superolateral displacement of the bilateral internal carotid arteries.
Radiologic finding confirmed diagnosis - Giant hypothalamic hamartoma. Differential diagnosis includes craniopharyngioma, pituitary macroadenoma, and germ cell tumor.

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