Mesenchymal Hamartoma Of Chest Wall Research Articles

A rare case of mesenchymal hamartoma of chest wall in a neonate

A rare case of mesenchymal hamartoma of chest wall in a neonate

Bilateral mesenchymal hamartoma of chest wall in a toddler: An uncommon clinical entity

Aim- Background: Bilateral chest wall mesenchymal hamartoma is a very rare lesion of infancy with distinct clinical, radiologic and pathologic characteristics. Computed tomography of the thoracic cavity is a very useful diagnostic tool. Histopathology examination offers the definite diagnosis. Report of a case: Herein we present a pediatric case of congenital bilateral mesenchymal hamartoma of the chest wall in a toddler. Both chest masses were surgically removed, when the boy appeared having clinical manifestations and respiratory compromise. As a result, the patient got fully recovered and free of any symptoms. Conclusions: As far as treatment of this uncommon tumorous condition is concerned, it is strongly supported that asymptomatic cases should be conservatively managed with close follow-up and periodic imaging. On the contrary, in cases presenting with clinical features, complete surgery treatment should be initiated and applied aiming the ultimate cure.

Bilateral chest wall mesenchymal hamartoma: Prenatal diagnosis and staged surgical resection

Mesenchymal hamartoma of the chest wall is a rare condition seen in infants. This case describes a prenatally diagnosed rapidly growing bilateral chest wall masses, suspected to be a mesenchymal hamartoma. Prenatal MRI performed at 33 weeks gestation showed large bilateral lesions with substantial mass effect in the form of pulmonary compression and displacement of the mediastinal structures necessitating delivery at our tertiary care facility at 35 weeks. At 48 hours post-birth, CTA revealed bilateral chest wall masses consistent with mesenchymal hamartoma and secondary aneurysmal bone cyst formation. The large left-sided lesion compressed the left lung and severely hindered pulmonary function, and the neonate required increasing respiratory support. The left-sided lesion was completely resected on day of life 15, and the neonate was extubated shortly after surgery. At the time of surgery the chest wall was reconstructed with alloderm, vicryl mesh and a latissimus dorsi advancement flap. A CTA at 3 months of age showed resection of the left-sided lesion with no evidence of recurrence, but significant growth in the unresected right hemithorax lesion. The right-sided lesion was resected uneventfully 8 months later. The prenatal and postnatal images showing the symptomatic lesion growth are discussed in this report.

Bilateral chest wall mesenchymal hamartomas treated with sclerotherapy and cryoablation

Abstract Mesenchymal hamartoma of the chest wall is a rare disorder, traditionally treated with mutilating radical excision. We report a case of an infant with bilateral mesenchymal hamartomas (MH) complicated with aneurysmal bone cyst (ABC) features. We subsequently describe a novel technique combining sclerotherapy and cryoablation to achieve non-operative tumor burden reduction in an effort to minimize disfigurement making the MH amenable to less morbid resection. A 3.5-month-old male presented with bilateral, complex, mixed cystic and solid, chest wall masses consistent with a chest wall mesenchymal hamartoma. Under ultrasound and fluoroscopic guidance, the aneurysmal bone cyst components were aspirated and contrast studies performed to exclude venous drainage. Doxycycline sclerotherapy was performed using dwelling volumes approximately 50–60% of the estimated cyst cavity size. Repeat sclerotherapy was performed on days 85, 147, 229 and 267, with interval imaging guiding timing and location of therapy. The ABC components responded well to sclerotherapy with significant size decrease of the cystic components. Overall lesion size decreased significantly, with new bone formation noted in response to treatment. The first treatment of computer tomographic (CT)-guided cryoablation was then performed on day 329 to attempt further reduce the size of the solid components. Multiple cryoablation probes were advanced into the mass under CT fluoroscopy. Deep components were treated initially with a series of freeze/thaw cycles. Cryoprobes were then retracted to treat the more superficial portions of the lesion. CT guided cryoablation was repeated on day 601.

Case of Mesenchymal Hamartoma of Chest Wall in Neonate

Case of Mesenchymal Hamartoma of Chest Wall in Neonate

Mesenchymal (chondromatous) hamartoma of chest wall in a neonate: A case report and review of literature

Mesenchymal hamartoma of chest wall (MHCW) is a rare benign chest wall tumor mostly presenting at birth or in the first year of life with typical clinical, radiological as well as histopathological features. Here we report a case of this rare entity which can be easily mistaken for a malignant tumor. In this case preoperative probable diagnosis of some malignant tumor was made on clinicoradiological features and the final diagnosis of MHCW was given histopathologically.

Mesenchymal hamartoma of the bilateral chest wall in neonates

A mesenchymal hamartoma of the chest wall is a rare benign tumor. Each case has a different clinical course as well as different radiological imaging findings, and various histopathological diagnoses. In addition, mesenchymal hamartoma is sometimes mistaken for a malignant tumor. This report presents a neonatal case of mesenchymal hamartoma of the bilateral chest wall.

Hamartoma mesenquimatoso de la pared torácica: presentación de un caso

Chest wall mesenchymal hamartoma is an extremely rare benign tumor. Approximately 80 cases have been reported in the literature. Most tumors are manifested at birth with a painless palpable mass of the chest wall, usually unilateral. Respiratory symptoms result from extrinsic compression of the pulmonary parenchyma, and the severity of the symptoms will depend on the size and location of the lesion. Imaging features are characteristic, but definitive diagnosis is histological. Herein, a case is described of a four month old infant with diagnosis of chest wall mesenchymal hamartoma, manifested at birth. Different treatment options are described, including expectations from tumor management, the possibility of spontaneous regression, and the morbidity associated with the surgical option.

Chest wall mesenchymal hamartoma associated with a massive fetal pleural effusion: a case report

We report on an extremely rare chest wall mesenchymal hamartoma associated with a massive fetal pleural effusion. Prenatal ultrasound examination demonstrated a heterogeneous mass in the right thorax associated with a massive pleural effusion and right lung compression at 29 weeks of gestation. The patient underwent pleuroamniotic shunting at 30 weeks and was delivered at 33 weeks by cesarean delivery secondary to fetal distress. After management of the respiratory distress and evaluation of the mass, surgery was performed at day of life 8. Histological examination confirmed the diagnosis of a chest wall mesenchymal hamartoma.

Mesenchymal hamartoma of the chest wall: radiologic manifestations with emphasis on cross-sectional imaging and histopathologic comparison.

To describe the imaging features of chest wall mesenchymal hamartoma with emphasis on cross-sectional imaging and comparison with histopathologic results. For 14 mesenchymal hamartomas of the chest wall in 12 children, radiologic studies (computed tomographic [CT] scans [n = 14], radiographs [n = 11], magnetic resonance [MR] images [n = 9], and bone scintigraphic images [n = 1]) were reviewed by four radiologists with consensus agreement. Clinical history was reviewed for patient demographics and symptoms at presentation. Radiologic studies were evaluated for lesion location, size, number of affected ribs, cortical irregularity or erosion, presence and type of matrix mineralization, lung hyperaeration adjacent to the lesion, degree and homogeneity of radionuclide uptake, and intrinsic characteristics on CT and MR images. Patients included seven male and five female children. Nine patients (75%) were younger than 1 year. Five patients had a chest wall mass; in the remaining seven, the lesion was discovered incidentally. All 14 lesions arose from ribs, 11 were located posteriorly, and 11 affected multiple contiguous ribs. Two patients had multifocal disease, each with two discrete lesions. Radiography in all cases revealed a large expansile rib lesion and an associated extrapleural soft-tissue mass, suggesting an aggressive process. Mineralization was seen in seven (64%) lesions at radiography and in 14 (100%) lesions at CT. Hemorrhagic cavities (secondary aneurysmal bone cyst [ABC] regions) were common, seen in nine (64%) lesions at CT and in four (80%) of five lesions imaged with T2-weighted MR imaging. Mesenchymal hamartoma of the chest wall may be recognized by its characteristic occurrence in infancy and cross-sectional imaging features of mineralization and hemorrhagic cystic (secondary ABC) components.