TYPnovel Chapter 467 - 344: Hypothalamic Hamartoma, Surgery
Chapter 467 - 344: Hypothalamic Hamartoma, Surgery
"Alright, I’ll head there immediately."
Zhang Qingquan, hearing this, excitedly jogged out.
"Director Qin, are you suspecting that the root cause of the patient’s sexual precocity is in the brain?"
The endocrinologist, upon hearing this, looked at Qin Feng with astonishment.
It is known that there are several causes of sexual precocity, and they occur in different locations.
In fact, many young children nowadays experience precocity due to excessive intake at home.
This includes residual hormones in animals and plants, environmental hormones, excessive intake of supplements, blind nourishment, etc.
With the rapid improvement in children’s living standards, their learning pressure has also increased.
To ensure children’s physical health and nutritional supply, parents purchase so-called children’s health supplements, cook various nutritious soups, including animal organs.
These may carry large amounts of hormones, which take time to balance after entering the child’s body.
If ingested over a long period and frequently, it can easily cause hormone levels to rise, leading to indications and physical changes of sexual precocity.
There is also a particularly special cause for precocity.
Premature psychological stimulation!
Currently, children spend a great deal of time with electronic products. Children may experience high-frequency psychological stimulation through some film clips, e-books, special websites, etc., leading to an increase in hormone levels and thus precocious conditions.
Therefore, parents must be cautious when letting children watch TV or play on phones to avoid exposing them to inappropriate content.
Regarding the third cause,
Most girls who experience precocity belong to idiopathic precocious puberty, also known as constitutional precocious puberty.
This is due to decreased sensitivity of the hypothalamus to sex hormone negative feedback and premature secretion of gonadotropin-releasing hormone.
This treatment only requires pharmaceutical assistance and daily management to lower hormone levels in the body and delay development speed to near-normal levels.
Generally, if a girl shows secondary sexual characteristics before the age of 8, it can basically be judged as precocious puberty.
However, this is divided into manifestations of sexual characteristics in different areas.
In simple cases of early breast development, this condition often begins before the age of 2, without accelerated growth and advanced bone age. Serum E and basal FSH levels are often mildly elevated, and FSH peak values increase in the GnRH stimulation test.
However, a small portion of patients may gradually develop into true precocious puberty.
Secondly is early hair growth.
It belongs to a special type of incomplete precocious puberty and can occur in both genders.
It commonly occurs around the age of 6, with axillary hair development except in private areas. There is no gonadal development possibly related to early adrenal function and premature secretion of a large amount of androgens.
The third situation involves young girls, which can now be excluded from consideration.
The final type, which no one wants to see,
is precocious puberty caused by organic lesions!
"Director Qin, do you mean a tumor?"
Pediatric attending physician Zhu Yijun heard this and immediately asked.
"Yes, I can basically determine that the child should have sexual precocity caused by a hypothalamic hamartoma."
Qin Feng nodded and stated his diagnostic conclusion.
"That’s indeed possible!"
Upon hearing this result, the two exchanged glances, slightly nodding.
It is indeed possible!
"If it really is a hypothalamic hamartoma, that would be a bit troublesome."
Zhu Yijun furrowed her brow, as the size and location of the hamartoma were still unknown, so they needed to wait for the results.
About ten minutes later,
finally, the brain CT arrived!
When the image appeared in the lightbox, Zhu Yijun and her colleague were stunned.
It really is!
"Director Qin, your judgment was correct, it is indeed a hypothalamic hamartoma."
Endocrinology attending physician He Yue couldn’t help but express her surprise.
She didn’t expect Qin Feng’s judgment to be so accurate. Although they also had suspicions, they would never dare to draw the correct conclusion based on only basic examinations like Qin Feng did.
This not only requires medical skills but also enough experience!
But how old is this young deputy director of the emergency department?
Under 30, still a Ph.D. candidate!
Rising from intensive care to deputy director of emergency in just one and a half years, that’s truly impressive!
Even rarer pediatric conditions like precocious puberty can be diagnosed!
"This tumor’s location is not great ~ "
At that moment, Qin Feng was carefully examining the CT, unable to help but frown slightly.
Because hypothalamic hamartomas are difficult to detect under regular X-rays and CT scans, only MRI’s three-dimensional imaging can reveal the lesion’s size and shape.
Most importantly, it can fully reveal the surrounding nerve structures, providing conditions for surgical complete resection of the tumor.
And now, based on CT’s three-dimensional imaging, this hamartoma’s boundaries with adjacent normal brain tissue are not very clear.
The entire tumor’s longest dimension exceeds 2.5 cm, requiring surgery.
Otherwise, the impact will be significant!
"Dr. Zhang, find a quiet ward for this little girl and prepare to admit her for hospitalization."
Qin Feng thought for a moment and then turned his head to say,
"Bring the child’s parents to the small conference room, and we’ll head there immediately."
"Alright, I understand."
Zhang Qingquan seemed particularly obedient tonight, which even surprised Qin Feng a little.
Since when did this guy become so obedient?
It even gave him a familiar feeling, almost like...
Zhao Yitian!
...
In the conference room,
Qin Feng, along with the pediatrician Zhu Yijun, the endocrinologist He Yue, and Zhang Qingquan, faced the parents of the little girl.
This was the time to explain the illness in detail, analyze it, and provide a basic treatment plan.
"Director Qin, doctors, we’ve done a ton of tests and dawn is breaking. Can you tell us what’s wrong with our Chenchen? What illness does she have?"
The father’s face looked bad, his eyes red, and he appeared haggard.
"Director, you just said our daughter has early puberty, what’s the cause of it?"
The mother was also anxious, repeatedly asking.
"Alright, we’re going to explain your child’s condition to you now, please don’t get too worked up."
Qin Feng raised his hand to signal, then opened the presentation,
"It’s like this: after our detailed examinations, we can now fully confirm that your daughter is experiencing early puberty. The bleeding you’ve noticed is a manifestation of secondary sexual characteristics, menstruation."
"Early puberty is not beneficial for a child. Early development can lead to an early end of growth, severely affecting not only the body but also the psychological state, and potentially the brain as well."
"And we have identified the cause of this illness, take a look."
Saying this, Qin Feng opened the 3D image,
"This is the cause of your daughter’s early puberty. Here is our hypothalamus, the highest center of endocrine function in the human body, and this shadow here is the cause.
Hypothalamic hamartoma."
"A tumor?"
Hearing this, the couple’s faces changed dramatically, especially the woman, who instantly went pale and almost fainted.
It’s known that, in normal life, the most terrifying words to hear are tumor and cancer!
In most cases, having a tumor isn’t a good prognosis.
Moreover, this time it’s their daughter’s brain tumor.
"Doctor, is it...serious?"
The child’s father adjusted his glasses and swallowed hard, stammering a bit.
"Like this, try not to be too anxious; this tumor is not quite what you think of as a tumor."
Seeing this, Qin Feng quickly explained,
"The hypothalamic hamartoma, also called grey tuber hamartoma, is a relatively rare congenital malformation of brain tissue, not something acquired later in life.
Since it occurs in the body’s most critical part, the lower part of the hypothalamus, where it forms a mass, it is called a hamartoma.
Some hamartomas stop growing once they reach a certain size and do not affect anything.
But your daughter’s, evidently, has affected her growth, so it needs treatment."
...
After this explanation, the couple finally calmed down a bit.
But their faces were still filled with tension and worry; although it wasn’t a tumor in the typical sense, the situation didn’t seem very good.
Hypothalamic hamartomas usually cause several conditions.
One is the most common, gelastic epilepsy, characterized by bouts of foolish laughter lasting seconds or tens of seconds and then stopping suddenly.
There is no loss of consciousness during episodes, which can occur several to dozens of times a day.
However, this condition manifests quite early, peaking around 1-2 years old.
The other is precocious puberty, just like the little girl now.
There may also be behavioral abnormalities and cognitive dysfunction, affecting intellectual development.
"As of now, your daughter’s hypothalamic hamartoma measures 2x2.5cm and shows signs of growth, which could lead to other issues if it continues.
Our recommendation is surgery!"
Having said this, Qin Feng looked at the couple in front of him.
Upon hearing this, the couple immediately became anxious.
Surgery?
This result was entirely unexpected; they thought their daughter was hurt, not that she was ill.
"Director Qin, can this condition be treated?"
The father asked proactively.
"We need to assess it further and also work with pediatrics to develop a surgical plan.
For now, the success rate of the surgery is still quite high."
Qin Feng nodded and explained.
"Then...we agree to the surgery."
The couple exchanged a glance, then nodded.
After all, this is Peking Union Medical College Hospital, one of the top national Class A tertiary hospitals.
"Okay, then you should handle the hospitalization first, tomorrow we’ll reconfirm the surgical treatment plan."
"Alright, alright, we’ll get it done immediately."