Surgical treatment and outcome of pulmonary hamartoma: a retrospective study of 20-year experience

Abstract

Background: Controversy still exists in the indication and timing of surgical treatment of pulmonary hamartoma (PH). The objective of this study is to summarize the experience and the outcome of the surgical treatment for pulmonary hamartomas, and to assess the effectiveness and necessity of surgical therapy administered in patients with pulmonary hamatoma as well as clinical and pathological features and long-term follow-up results.

Pulmonary Hamartomas: A Report of 13 Parenchymal and Endobronchial Cases

“…These tumors are predominantly composed of cartilage. Other components include fibromyxoid connective tissue, fat, bone, and smooth muscle (1)(2)(3)(4)(5). Most tumors of the tracheabronchial tree are malignant.…”

“…They are distributed throughout both lungs. While Guo et al (1) reported that in terms of the location of the lesions, there was no significant difference between the right and the left lung, Fudge et al (6) found that the lesions were located in the right lung in 20 of the 29 patients. Two previous studies were reported that all lobes were affected, with a preponderance in the upper lobes (5, 6).…”

“…On chest X-ray examination, a parenchymal hamartoma usually shows up a solitary pulmonary nodule, sometimes with calcification (3). Multiple nodules or a mass lesion can be seen on chest radiographs (1,3). Endobronchial lesions may not be visible themselves, but conventional radiography may show postobstructive changes such as pneumonia, atelectasis, or lung abcess (7,9).…”

“…However, indication and timing of surgery are still controversial. Since most pulmonary hamartomas are nonexpanding or slowly growing neoplasms, some authors believed that surgery is necessary only when expansion is recorded in young or middle aged patients or accompanying obvious pulmonary symptoms (1,6,8). According to Guo et al (1), the pulmonary hamartomas have the tendency of expansion or recurrence, and chronic inflammatory stimulation of local position may contribute to the development of malignancy.…”

“…Therefore, when a solitary pulmonary lesion is more than 2.5 cm or the possibility of malignancy cannot be excluded, surgical resection should be mandatorily performed. The pulmonary hamartomas are removed by wedge resection or enucleation of the tumor (1,3,5). Only the tumors located deeply in the parenchyma or endobronchial lesions necessitate more extensive procedures such as lobectomy or pneumonectomy (3,5).…”