Recurrent hamartoma at the trocar incision site after video-assisted thoracic surgical resection

Abstract

T he most common benign tumor of the lung is the hamartoma representing 77%. Hamartomas represent 4% to 8% of all solitary pulmonary nodules, which present themselves as well-circumscribed, asymptomatic coin lesions within the pulmonary parenchyma. Usually they are chondromatous hamartomas consisting of cartilage and are regarded as benign neoplasms derived from the peribronchial mesenchymal tissue. Symptoms such as cough, hemoptysis, or pulmonary infections arise only when the location is endobronchial, which is rare (10%). There is an overall incidental finding in approximately 0.25% of autopsies, and hamartomas are found more frequently in men than in women (2:1). Multiple hamartomas are rare and do not include cartilage but pulmonary muscular or endothelial tissue and are therefore called hemangioleiomyomatous and fibroleiomyomatous hamartomas. In the case of a solitary lesion it is necessary to exclude malignancy. Percutaneous, transthoracic computed tomographyguided needle aspiration biopsy yields diagnosis in 85% of solitary pulmonary coin lesions. The risk of pneumothorax is high, ranging from 20% to 24%. Video-assisted thoracic surgical (VATS) resection offers a safe and 100% sure method to obtain a diagnosis with little discomfort for the patient. Most authors recommend enucleation or tissue-sparing resection of the chondromatous hamartoma. Recurrence after excision is practically unknown.