Cytohistomorphological identification of congenital bilateral mesenchymal hamartoma of chest wall

Abstract

Cases of Congenital hamartoma of the chest wall in infants are rare and their bilateral involvement is extremely rare. An 18 month-old child presented with bilateral chest wall swellings since birth which were gradually increasing in size. The X-Ray of the chest wall revealed bilateral involvement of 1st, 2nd and 3rd ribs with involvement of extra-pleural soft tissues. The cytological diagnosis given was round cell tumor of the chest wall keeping in view the presence of round cells in a hemorrhagic background. The biopsy revealed areas showing mature cartilage, bone, fibrous tissues along with hemorrhagic cystic cavities. Basing on the biopsy report, final diagnosis of chest wall hamartoma was given. Following complete excision, the child was doing well and there was no recurrence of the lesion as observed in the follow-up sessions.

Multifocal Chest Wall Hamartoma: A Rare Congenital Anomaly

“…hamartoma, the name coined by McLeod and Dahlin, as it is an abnormal proliferation of normal skeletal elements. It is a very rare benign bony lesion, which usually arise from ribs and affect contiguous ribs[4] [5]. In our case, there are bilateral and multifocal lesions, which is a very rare occurrence.…”

“…It causes focal/ multifocal expansion, morphological distortion and can present as small to large masses with extraosseous component[6]. It usually causes symptoms due to its large size with resultant compressive symptoms over lung and mediastinum and chest wall deformity[5] [7]. Our patient presented with chest wall deformity, cough and respiratory distress soon after birth.In our case, a complex chest mass was detected during routine antenatal ul-trasound at 22 nd week and differential diagnosis of teratoma, adenomatoid malformation or chest wall mass was kept.…”