Abstract: Objective To investigate the treatment strategy and outcome of central precocious puberty(CPP)secondary to hypothalamic hamartoma(HH)in children. Methods The clinical data of a girl with HH presenting with vaginal bleeding and breast development were retrospectively analyzed. The word “hypothalamic hamartoma” was used as a keyword to retrieve literature. Results The female patient presented with intermittent vaginal bleeding and breast development at the age of 4 months after birth aged 3 years and 11 months at the time of diagnosis, and was diagnosed as “central precocity and grey nodular hamartoma.” After 1-year treatment with gonadotropin-releasing hormone analogs(GnRHa), her height did not increase as desired and the prediction was that her height would be impaired when she grew up. After that, recombinant human growth hormone(rhGH)was added, and the combination therapy was terminated after 3.5 years when the girl was 8.5 years old. Regular menstruation resumed 1 year after medications withdrawal. At the age of 10 years and 7 months, her height reached 164.8 cm, higher than the target height. Reexamination showed that sex hormones were normal and no adverse reactions were observed. MRI of pituitary gland showed no changes in tumor size and location. Conclusion CPP secondary to HH can occur in infancy, which needs to be differentiated from mini-puberty. GnRHa is recommended; combination treatment with rhGH should be administered when the patients’ height may be affected, which is not only safe, but highly effective.

Key words: Hypothalamic hamartoma, Infancy, Central precocious puberty, Gonadotropin-releasing hormone analogs, Recombinant human growth hormone