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Dong N, Meng F, Yue B, Hou J. Clinicopathologic and endoscopic characteristics of ten patients with gastric hamartomatous inverted polyp: a single center case series. BMC Gastroenterol 2024; 24:139. [PMID: 38649806 PMCID: PMC11034083 DOI: 10.1186/s12876-024-03233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Gastric hamartomatous inverted polyps (GHIPs) are not well characterized and remain diagnostically challenging due to rarity. Therefore, this study aims to investigate the clinicopathologic and endoscopic characteristics of patients with GHIP. METHODS We retrospectively reviewed clinicopathologic and endoscopic features of ten patients with GHIP who were admitted to Beijing Friendship Hospital from March 2013 to July 2022. All patients were treated successfully by endoscopic resection. RESULTS GHIPs were usually asymptomatic and found incidentally during gastroscopic examination. They may be sessile or pedunculated, with diffuse or local surface redness or erosion. On endoscopic ultrasonography, the sessile submucosal tumor-type GHIP demonstrated a heterogeneous lesion with cystic areas in the third layer of the gastric wall. Histologically, GHIPs were characterized by a submucosal inverted proliferation of cystically dilated hyperplastic gastric glands accompanied by a branching proliferation of smooth muscle bundles. Inflammatory cells infiltration was observed in the stroma, whereas only one patient was complicated with glandular low-grade dysplasia. Assessment of the surrounding mucosa demonstrated that six patients (60%) had atrophic gastritis or Helicobacter pylori-associated gastritis, and four patients (40%) had non-specific gastritis. Endoscopic resection was safe and effective. CONCLUSIONS GHIPs often arise from the background of abnormal mucosa, such as atrophic or H.pylori-associated gastritis. We make the hypothesis that acquired inflammation might lead to the development of GHIPs. We recommend to make a full assessment of the background mucosa and H. pylori infection status for evaluation of underlying gastric mucosal abnormalities, which may be the preneoplastic condition of the stomach.
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Affiliation(s)
- Ningning Dong
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory for Digestive Health, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
| | - Fandong Meng
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory for Digestive Health, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
| | - Bing Yue
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Junzhen Hou
- Department of Gastroenterology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, 24 Shi-Jing-Shan Road Shi-Jing-Shan District, Beijing, 100040, China.
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Zhang W, Tang LX, Wang PP, Chen XX, Yang XJ, Xiao X, Han Y, Ge WT. [Clinical characteristics, diagnosis and treatment of nasal cartilage mesenchymal hamartoma in infants]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:373-378. [PMID: 38622021 DOI: 10.3760/cma.j.cn115330-20231012-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Objective: To explore the clinical characteristics, pathological features, and diagnosis and treatment strategies of nasal chondromesenchymal hamartoma (NCMH) in infants and young children. Methods: A retrospective analysis was conducted on seven cases of NCMH infants and young children admitted to Beijing Children's Hospital, Capital Medical University from April 2015 to January 2022. The cohort included 5 males and 2 females, aged from 6 days to 2 years and 3 months. General information, clinical symptoms, imaging findings, treatment plans, postoperative complications, recurrence and follow-up time were collected, summarized and analyzed. Additionally, immunohistochemical characteristics of the lesion were examined. Results: The clinical symptoms of 7 children included nasal congestion, runny nose, open mouth breathing, snoring during sleep, difficulty feeding, and strabismus. All patients underwent electronic nasopharyngoscopy examination, with 5 cases of tumors located in the right nasal cavity and 2 cases in the left nasal cavity. No case of bilateral nasal cavity disease was found. All 7 patients underwent complete imaging examinations, with 5 patients underwent MRI and CT examinations, 1 patient underwent CT examination only, and 1 patient underwent MRI examination only. The CT results showed that all tumors were broad-based, with uneven density, multiple calcifications and bone remodeling, and some exhibited multiple cystic components. The MRI results showed that the tumor showed low signal on T1 weighted imaging and high or slightly high signal on T2 weighted imaging. All patients were diagnosed through histopathological examination and immunohistochemistry, including 7 cases of Ki-67 and SMA (+), 5 cases of S-100 and Vimentin (+), and all EMA and GFAP were negative. All patients underwent endoscopic resection surgery through the nasal approach, with 3 cases using navigation technology. Five cases of tumors were completely removed, and two cases of tumors were mostly removed. No nasal packing was performed after surgery, and no postoperative nasal, ocular, or intracranial complication occurred in all patients. Follow up assessments conducted 6 to 84 months post-surgery revealed no instances of tumor recurrence in any of the patients. Conclusions: The clinical symptoms of children with NCHM mainly depend on the size and location of the tumor. Nasal endoscopic surgery is the main treatment method. In cases where critical structures like the skull base or orbit are implicated, staged surgical interventions may be warranted. Long-term follow-up is strongly advised to monitor for any potential recurrence or complications.
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Affiliation(s)
- W Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - L X Tang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - P P Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X X Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X J Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X Xiao
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y Han
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - W T Ge
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Chi Y, Chen J, Zhou M, Xu F. Hamartoma of the breast: A rare case report. Asian J Surg 2024; 47:1849-1850. [PMID: 38182521 DOI: 10.1016/j.asjsur.2023.12.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/25/2023] [Indexed: 01/07/2024] Open
Affiliation(s)
- Yongxing Chi
- Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Jia Chen
- Shaoxing People's Hospital, Shaoxing, 312000, China; School of Medicine, ShaoXing University, Shaoxing, 312000, China
| | - Minghui Zhou
- Shaoxing People's Hospital, Shaoxing, 312000, China; School of Medicine, ShaoXing University, Shaoxing, 312000, China
| | - Feng Xu
- Shaoxing People's Hospital, Shaoxing, 312000, China.
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Andrews C, Aronson L, Church M, Piegols H. Dorsal rhinotomy in a dog with a chondro-osseous respiratory epithelial adenomatoid hamartoma: a case report. J Am Vet Med Assoc 2024; 262:1-4. [PMID: 38183769 DOI: 10.2460/javma.23.10.0559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE To describe the clinical presentation, novel surgical approach, and outcome of a dog diagnosed with chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH). ANIMAL 5-year-old castrated male Yorkshire Terrier. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES The dog was presented with chronic upper respiratory noise, congestion, facial swelling, ocular discharge, and an abscess on the nasal bridge. Two CT scans were performed 4 months apart. The CT scans yielded similar results: cyst-like nasal masses with severely destructive bilateral rhinitis with extensive polyostotic bony lysis. A dorsal rhinotomy with a turbinectomy and debridement of the nasal cavity were performed. A poorly defined but extensive lesion was found occupying the entirety of the left frontal sinus as well as the nasal cavity. TREATMENT AND OUTCOME Histopathology revealed a mass consistent with COREAH. The dog recovered well from surgery, except for self-limiting subcutaneous emphysema, and 3 weeks postoperatively was reportedly doing well, with mild nasal discharge. Stridor, nasal discharge, and sneezing episodes were reported postoperatively; however, these were improved. At 18 months postoperatively, the dog died from uncontrolled seizures while hospitalized for suspected acute hemorrhagic diarrhea syndrome at a different hospital. CLINICAL RELEVANCE COREAH should be considered a potential cause of destructive bilateral rhinitis and bony lysis in dogs. Dorsal rhinotomy can be a surgical treatment for dogs with possible COREAH with acceptable outcome, though complete remission of clinical signs may not be achieved. This is the first clinical description of COREAH in a dog.
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Avsenik J, Albalkhi I, Prabhu SP, Radhakrishnan R, Goetti R, Jaju A, Merve A, Biswas A, Mankad K. Pediatric nasal chondromesenchymal hamartomas: a case series. Neuroradiology 2024; 66:437-441. [PMID: 38206352 DOI: 10.1007/s00234-023-03276-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Nasal chondromesenchymal hamartomas (NCMH) are rare, predominantly benign tumors of the sinonasal tract. The distinction from higher grade malignancy may be challenging based on imaging features alone. To increase the awareness of this entity among radiologists, we present a multi-institutional case series of pediatric NCMH patients showing the varied imaging presentation. METHODS Descriptive assessment of imaging appearances of the lesions on computed tomography (CT) and magnetic resonance imaging (MRI) was performed. In addition, we reviewed demographic information, clinical data, results of genetic testing, management, and follow-up data. RESULTS Our case series consisted of 10 patients, with a median age of 0.5 months. Intraorbital and intracranial extensions were both observed in two cases. Common CT findings included bony remodeling, calcifications, and bony erosions. MRI showed heterogeneous expansile lesion with predominantly hyperintense T2 signal and heterogenous post-contrast enhancement in the majority of cases. Most lesions exhibited increased diffusivity on diffusion weighted imaging and showed signal drop-out on susceptibility weighted images in the areas of calcifications. Genetic testing was conducted in 4 patients, revealing the presence of DICER1 pathogenic variant in three cases. Surgery was performed in all cases, with one recurrence in two cases and two recurrences in one case on follow-up. CONCLUSION NCMHs are predominantly benign tumors of the sinonasal tract, typically associated with DICER1 pathogenic variants and most commonly affecting pediatric population. They may mimic aggressive behavior on imaging; therefore, awareness of this pathology is important. MRI and CT have complementary roles in the diagnosis of this entity.
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Affiliation(s)
- Jernej Avsenik
- Clinical Institute of Radiology, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia.
- Department of Radiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | | | - Sanjay P Prabhu
- Division of Neuroradiology, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert Goetti
- Department of Medical Imaging, The Children's Hospital at Westmead, New South Wales, Australia
| | - Alok Jaju
- Department of Medical Imaging, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Ashirwad Merve
- Neuropathology Department, Great Ormond Street Hospital, London, UK
| | - Asthik Biswas
- Department of Neuroradiology, Great Ormond Street Hospital, London, UK
| | - Kshitij Mankad
- Department of Neuroradiology, Great Ormond Street Hospital, London, UK
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Tsolaki F, Tagarakis GI, Tagarakis I. When to anatomically excise a benign lung tumor-correspondence regarding the article: "large mesenchymal cystic and chondroid pulmonary hamartoma mimicking lung cancer: case report". J Cardiothorac Surg 2024; 19:82. [PMID: 38336782 PMCID: PMC10858531 DOI: 10.1186/s13019-024-02554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
The decision of whether to perform a large anatomic resection for a lung mass that is not definitely malignant comes often forward in the everyday practice of the thoracic surgeon. The general characteristics of the tumor as well as of the patient and the instinct and experience of the surgeon are the ones that dictate the final choice. Such a decision was made in the case of a large pulmonary hamartoma where a right middle lobectomy was performed with the postoperative course justifying the surgeons' choice.
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Affiliation(s)
- Fani Tsolaki
- Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece
| | - Georgios I Tagarakis
- Department of Cardiothoracic Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, 54636, Greece.
| | - Ioannis Tagarakis
- Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece
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7
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Yuan CC, Zhai CW, Wang SY, Lin L. [Clinicopathological analysis of four cases of seromucinous hamartoma in the nasal cavity]. Zhonghua Bing Li Xue Za Zhi 2024; 53:186-188. [PMID: 38281790 DOI: 10.3760/cma.j.cn112151-20230829-00105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Affiliation(s)
- C C Yuan
- Department of Pathology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - C W Zhai
- Department of Pathology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - S Y Wang
- Department of Pathology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - L Lin
- Department of Pathology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
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8
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Zou J, Luo P, Chen T, Qian B. Postoperative pleural effusion and pulmonary infection occurring in a patient with pulmonary hamartoma. Asian J Surg 2024; 47:1324-1325. [PMID: 38042654 DOI: 10.1016/j.asjsur.2023.11.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 11/17/2023] [Indexed: 12/04/2023] Open
Affiliation(s)
- Jun Zou
- The First Clinical Medical School of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China
| | - Peiyue Luo
- The First Clinical Medical School of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China
| | - Tao Chen
- The First Clinical Medical School of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China
| | - Biao Qian
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China.
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9
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Machuca-Aguado J, González-Fernández J, Rodríguez-Zarco E, González-Cámpora R, García-Escudero A. Adenomyomatous Pulmonary Hamartoma: Regarding a Case. Int J Surg Pathol 2024; 32:209-211. [PMID: 37013272 DOI: 10.1177/10668969231166304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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10
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Jianmongkol S, Homklai K, Sumananont C, Vinitpairot C. Lipofibromatous Hamartoma of the Median Nerve - A Rare Condition in the Hand. J Hand Surg Asian Pac Vol 2024; 29:64-68. [PMID: 38299243 DOI: 10.1142/s2424835524720020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Lipofibromatous hamartoma (LFH) of the median nerve is a rare condition in the hand and often remains asymptomatic for a significant period. MRI imaging can reveal unique tumour characteristics; however, the definitive diagnosis is confirmed through a tissue biopsy. In this report, a 38-year-old male presented with a gradually growing mass on his right hand. Physical examination revealed a large soft tissue mass extending from the thenar area to the wrist, causing compression of the median nerve. MRI confirmed the presence of a distinct soft tissue mass on the volar side of the hand. The mass was excised along with a fascicle and confirmed by histological examination. One year after surgery, sensation has improved, but weakness remains and opponensplasty was offered to the patient. Although the treatment strategy of LFH of the median nerve remains controversial, delayed treatment can result in severe compressive neuropathy and irreversible nerve damage. Level of Evidence: Level V (Therapeutic).
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Affiliation(s)
- Surut Jianmongkol
- Hand and Reconstructive Unit, Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kittiphong Homklai
- Hand and Reconstructive Unit, Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chat Sumananont
- Hand and Reconstructive Unit, Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chaiyos Vinitpairot
- Hand and Reconstructive Unit, Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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11
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Mongardini FM, Nazzaro L, Fuschillo G, D'Alelio A, Gambardella C, Docimo L, Lauro A, Landolfi V. Gentle Giant? Giant Gastric Solitary Peutz-Jeghers Polyp. Dig Dis Sci 2024; 69:349-354. [PMID: 38183558 DOI: 10.1007/s10620-023-08240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024]
Abstract
Solitary hamartomatous polyps with identical pathological features of the typical hamartomas of the Peutz-Jegher syndrome are extremely rare. These solitary lesions lack the associated intestinal polyposis, classic mucocutaneous pigmentation, and family history typifying the Peutz-Jegher syndrome. We describe the case of a 31-year-old woman with a giant solitary gastric hamartoma endoscopically diagnosed and laparoscopically resected.
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Affiliation(s)
- F M Mongardini
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", 80131, Naples, Italy.
| | - L Nazzaro
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - G Fuschillo
- Department of Advanced Medical and Surgical Sciences, Colorectal Surgery, University of Study of Campania «Luigi Vanvitelli», 80131, Naples, Italy
| | - A D'Alelio
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - C Gambardella
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - L Docimo
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - A Lauro
- Department of Surgery, Sapienza University, 00185, Rome, Italy
| | - V Landolfi
- General Surgery Unit, "St. Giuseppe Moscati" Hospital of National Relevance and High Specialty, 83100, Avellino, Italy
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Shmais M, Mousawi A, Mourad F, Sharara AI. Brunner's gland hamartomas: Not always benign. Arab J Gastroenterol 2024; 25:70-73. [PMID: 38296695 DOI: 10.1016/j.ajg.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 02/02/2024]
Abstract
Brunner's gland hamartoma (BGH) is a rare, benign tumor of the duodenum. It is mostly asymptomatic and usually found incidentally on routine esophagogastroduodenoscopy (EGD). However, some BGHs present with major complications including anemia, bleeding, obstruction, or dysplasia, requiring management and resection of these lesions. Herein, we present two cases of large BGHs of the duodenum, one presenting as severe gastrointestinal bleeding and the other, noted on EGD for iron deficiency anemia, found to have high grade dysplasia. This literature review discusses the rare serious complications of BGH, including iron deficiency anemia, overt gastrointestinal bleeding, and malignant potential.
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Affiliation(s)
- Manar Shmais
- Division of Gastroenterology and Hepatology, Saint Louis University Hospital, MO, USA.
| | - Ahmad Mousawi
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon.
| | - Fadi Mourad
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon.
| | - Ala I Sharara
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon.
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13
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Gou XN, Xu W, Dong ZH, Wang ZB. [Clinicopathological analysis of adult hepatic mesenchymal hamartoma]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:58-63. [PMID: 38320792 DOI: 10.3760/cma.j.cn501113-20231124-00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Objective: To explore the clinicopathological and molecular genetic features of adult hepatic mesenchymal hamartoma (MHL). Methods: A total of five confirmed adult MHL cases diagnosed at the Pathology Department of the First Medical Center of the People's Liberation Army General Hospital between 2009 and 2022 were collected. Histomorphological observation and immunohistochemical staining were conducted. Gene detection was performed by next-generation sequencing. Results: Among the five cases, four were male and one was female, aged 46-67 years, with an average age of 56.2 years. The maximum diameter was 5.3-13.5cm, and the average diameter was 9.2cm. Tumors were generally cystic, solid, or mixed cystic-solid. Histopathologically, in four out of five cases of MHL, malignant transformation occurred, of which three cases were malignantly transformed into undifferentiated embryonal sarcoma and one case was malignantly transformed into a malignant solitary fibrous tumor. NAB2-STAT6 gene rearrangements were identified. Conclusion: Adult MHL is a rare kind of tumor with malignant potential, and it is difficult to diagnose with preoperative imaging examinations. A fine-needle biopsy is rarely used for diagnosis, but surgical resection of symptomatic or enlarged lesions is recommended to rule out the possibility of malignancy and further diagnosis. Genetic testing results revealed the complex genetic alterations in MHL, and it was found that adult MHL can malignantly transform into malignant solitary fibrous tumors. We believe that genome-wide analysis is necessary to determine the unique molecular characteristics of MHL and identify potential targets for therapeutic intervention.
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Affiliation(s)
- X N Gou
- Department of Pathology, the First Medical Center of PLA General Hospital, Beijing 100853, China
| | - W Xu
- Department of Radiology, the First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Z H Dong
- Department of Pathology, the First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Z B Wang
- Department of Pathology, the First Medical Center of PLA General Hospital, Beijing 100853, China
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14
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Corvino S, d'Avanzo S, Alati C, Nenna R, Iaffaldano GC, Catapano D. Sporadic Spinal Hamartoma in Adults: A Rare Pathologic Entity. World Neurosurg 2024; 181:e242-e251. [PMID: 37838161 DOI: 10.1016/j.wneu.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Sporadic spinal hamartomas in adults are extremely rare tumor-like lesions, without defined guidelines of treatment. The aim of this study is to investigate the peculiar features of this pathologic entity to support a more accurate diagnosis and management. METHODS A comprehensive and detailed literature review of sporadic spinal hamartomas in adults, including a personal case, was performed. Demographic (sex and age), clinical (presenting symptoms), radiologic and pathologic (size, localization, dural and spinal cord relationship of lesion) features, as well as treatment (time to surgery, extent of resection, perioperative and postoperative complications) and outcome (clinical) data were analyzed. RESULTS Seven studies, including 7 patients, were eligible for the review. A personal case was also added. Sporadic adult spinal hamartomas equally affect males and females, in a range of age from 18 to 75 years; sensory radicular deficits were detected in all patients at clinical onset; thoracic segment (4/8) of the spine and intradural compartment (6/8) were most involved. All patients underwent surgery and just one experimented postoperative complication; gross total resection was achieved in only 3 patients, mainly in an extradural localization; clinical improvement at last follow-up was reported in all but 1 patient. CONCLUSIONS Spinal hamartomas in adults may sometimes account for progressive worsening of neurologic symptoms and lead to potentially irreversible neurologic deficit; therefore, prompt and adequate diagnosis and treatment are mandatory. Surgical resection represents the only curative treatment and is indicated for symptomatic lesions to achieve neurologic symptoms restoration or arrest/prevent their progressive deterioration.
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Affiliation(s)
- Sergio Corvino
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, Naples, Italy.
| | - Stefania d'Avanzo
- Department of Neurosurgery, "Bonomo" Hospital, Andria, Barletta-Andria-Trani, Italy
| | - Corrado Alati
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, Naples, Italy
| | - Rosanna Nenna
- Department of Pathology, "Bonomo" Hospital, Andria, Barletta-Andria-Trani, Italy
| | | | - Domenico Catapano
- Department of Neurosurgery, "Bonomo" Hospital, Andria, Barletta-Andria-Trani, Italy
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15
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Yancoskie AE, Trochesset DA, Merer D, Fantasia JE, Kumar AM. Oral leiomyomatous hamartoma: presentation of 3 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e1-e7. [PMID: 38619102 DOI: 10.1016/j.oooo.2023.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/05/2023] [Accepted: 07/26/2023] [Indexed: 04/16/2024]
Abstract
Oral leiomyomatous hamartoma (OLH) is a rare lesion, with only 40 cases reported in the literature. It typically presents early in life as a nodule on the anterior maxillary alveolar tissues or the tongue. Its growth potential is limited, with few cases reaching dimensions >2.0 cm, and its microscopic composition includes an intact surface mucosa with an underlying fibrovascular stroma possessing an unencapsulated proliferation of smooth muscle fascicles. Excision is considered the definitive treatment. Here we describe the clinical, microscopic, histochemical, and immunohistochemical features and management of 3 cases of OLH and review the literature. The findings we present here can assist in performing differential diagnosis, particularly in discriminating between OLH and similar yet non-hamartomatous processes and in selecting appropriate management.
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Affiliation(s)
- Aaron E Yancoskie
- Touro College of Dental Medicine at New York Medical College, Hawthorne, NY, USA; New York Medical College, Valhalla, NY, USA.
| | - Denise A Trochesset
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | | | - John E Fantasia
- Zucker Hofstra/Northwell School of Medicine LIJMC, New Hyde Park, NY, USA
| | - Arthi M Kumar
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
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16
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Galimova RM, Illarioshkin SN, Safin SM, Buzaev IV, Nabiullina DI, Krekotin DK, Nurmukhametova SR, Sidorova YA, Akhmadeeva GN, Kashapov FF, Yakupov TZ, Teregulova DR. [Hypothalamic hamartoma dissection using focused ultrasound under MRI control. The first successful experience in Russia]. Zh Vopr Neirokhir Im N N Burdenko 2024; 88:79-87. [PMID: 38334734 DOI: 10.17116/neiro20248801179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Treatment of motor disorders by MRI-guided focused ultrasound is an alternative to neuro- and radiosurgery such as stereotactic radiofrequency ablation and thalamotomy with a gamma knife. However, safety, efficacy and feasibility of this technology for intracranial neoplasms are still unclear. The authors report successful hypothalamic hamartoma dissection by MRI-guided focused ultrasound in a 32-year-old woman with drug-resistant gelastic epilepsy and violent laughter and crying attacks. Magnetic resonance imaging revealed type II hypothalamic hamartoma. The last one was detached from surrounding brain tissue by MRI-guided focused ultrasound without side effects. Symptoms regressed immediately after surgery. No laughter and crying attacks were observed throughout 6-month follow-up.
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Affiliation(s)
- R M Galimova
- Bashkir State Medical University, Ufa, Russia
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
| | | | - Sh M Safin
- Bashkir State Medical University, Ufa, Russia
| | - I V Buzaev
- Bashkir State Medical University, Ufa, Russia
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
| | - D I Nabiullina
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
| | - D K Krekotin
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
| | - S R Nurmukhametova
- Bashkir State Medical University, Ufa, Russia
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
- Group of companies «Mother and child», Ufa, Russia
| | - Yu A Sidorova
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
| | - G N Akhmadeeva
- Bashkir State Medical University, Ufa, Russia
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
| | | | - T Z Yakupov
- Group of companies «Mother and child», Ufa, Russia
| | - D R Teregulova
- Intelligent Neurosurgery Clinic of the Buzaev International Medical Center, Ufa, Russia
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17
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Park TH, Kim KH, Kim SK, Wang KC, Park SH, Lee JY. Fibrous hamartoma of infancy of the spinal cord resembling conus and filum, with a coexisting sacral dimple. Childs Nerv Syst 2024; 40:245-251. [PMID: 37653072 DOI: 10.1007/s00381-023-06133-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
Fibrous hamartoma of infancy (FHI) is a rare benign soft tissue lesion of infants and young children. It usually occurs within the first 2 years of life at the superficial layer of the axilla, trunk, upper arm, and external genitalia. FHI in the central nervous system (CNS) is extremely rare. So far, only two spinal cord FHI cases have been reported. We present a case of a 1-month-old girl who presented with a skin dimple in the coccygeal area. Her MRI showed a substantial intramedullary mass in the thoracolumbar area with a sacral soft tissue mass and a track between the skin lesion to the coccygeal tip. Her normal neurological status halted immediate surgical resection. A skin lesion biopsy was first performed, revealing limited information with no malignant cells. A short-term follow-up was performed until the intramedullary mass had enlarged on the 5-month follow-up MRI. Based on the frozen biopsy result of benign to low-grade spindle cell mesenchymal tumor, subtotal resection of the mass was done, minimizing damage to the functioning neural tissue. Both the skin lesion and the intramedullary mass were diagnosed as FHI. Postoperative 5.5-year follow-up MRI revealed minimal size change of the residual mass. Despite being diagnosed with a neurogenic bladder, the patient maintained her ability to void spontaneously, managed infrequent UTIs, and continued toilet training, all while demonstrating good mobility and no motor weakness. This case is unique because the lesion resembled the secondary neurulation structures, such as the conus and the filum, along with a related congenital anomaly of the dimple.
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Affiliation(s)
- Tae-Hwan Park
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Kyung Hyun Kim
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Kyu-Chang Wang
- Neuro-oncology Clinic, Center for Rare Cancers, National Cancer Center, Goyang, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Ji Yeoun Lee
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Republic of Korea.
- Department of Anatomy and Cell Biology, Seoul National University, College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
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18
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Lucà S, Montella M, Monti R, Accardo M, Savarese G, Sirica R, Fiorelli A, Morgillo F, Franco R. Pulmonary leiomyosarcoma arising in pulmonary hamartoma: an exceptional occurrence in a rare tumor. Pathologica 2023; 115:325-332. [PMID: 38180140 PMCID: PMC10767797 DOI: 10.32074/1591-951x-941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 01/06/2024] Open
Abstract
A solitary peripheral lung nodule was found in the left lung of a 52-year-old man. It was located in the lower lobe and measured 18.5 cm of major axis on chest computed tomography. A tru-cut core biopsy was obtained and a proliferation of bland, monomorphic, spindle cells in interlacing fascicles was observed. Accordingly, a surgical resection of the neoplasm was subsequently carried out. Macroscopically, the tumor appeared as a well-circumscribed nodule with a firm and whitish cut surface. Histologically, the neoplasm was predominantly composed of bland and monomorphic spindle cells, with a predominantly fascicular growth pattern, in which many tubular and cleft-like spaces of entrapped normal respiratory epithelium were involved. Myxoid change, stromal hyalinization and scattered bizarre mononucleated and multinucleated cells were also observed. Based on clinico-morphological, immunophenotypical and molecular features, we made a diagnosis of malignant transformation of pulmonary adenoleiomyomatous hamartoma into pulmonary leiomyosarcoma. As far as we know, this is the first described case of this exceptionally rare occurrence in an already rare neoplasm.
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Affiliation(s)
- Stefano Lucà
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
| | - Riccardo Monti
- Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
| | | | - Roberto Sirica
- AMES-Centro Polidiagnostico Strumentale, SRL, Naples, Italy
| | - Alfonso Fiorelli
- Division of Thoracic Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Floriana Morgillo
- Department of Precision Medicine, Medical Oncology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Campania, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “L. Vanvitelli”, Naples, Italy
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19
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周 智, 陈 文, 刘 佳, 付 勇. [Piriform sinus hamartoma in children: a case report and literature review]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:964-967;971. [PMID: 38114313 PMCID: PMC10985686 DOI: 10.13201/j.issn.2096-7993.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Indexed: 12/21/2023]
Abstract
Objective:To investigate the clinical manifestations and treatment of laryngopharynx hamartoma in children. Methods:The clinical data of a child with piriform sinus hamartoma treated in our hospital were analyzed retrospectively. The age, gender, clinical manifestations, auxiliary examination, location of the tumor and surgical methods were analyzed. Results:The patient had a good prognosis after surgery, and no tumor recurrence was found after 1 year of follow-up. Conclusion:Laryngopharynx hamartoma is rare in children. It should be considered in children with laryngeal dysfunction and upper airway obstruction. Complete resection of the tumor is the key to postoperative recurrence.
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Affiliation(s)
- 智英 周
- 浙江大学医学院附属儿童医院耳鼻咽喉头颈外科(杭州,310052)Department of Otolaryngology Head and Neck Surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - 文欣 陈
- 浙江大学医学院附属儿童医院耳鼻咽喉头颈外科(杭州,310052)Department of Otolaryngology Head and Neck Surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - 佳 刘
- 浙江大学医学院附属儿童医院耳鼻咽喉头颈外科(杭州,310052)Department of Otolaryngology Head and Neck Surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - 勇 付
- 浙江大学医学院附属儿童医院耳鼻咽喉头颈外科(杭州,310052)Department of Otolaryngology Head and Neck Surgery, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
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20
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Dash S, Chauhan S, Sennimalai K, Kharbanda OP, Singhal M. A Rare Case of Cleft Palate Associated With Tongue Hamartoma: A Case Report and Systematic Review. Cleft Palate Craniofac J 2023; 60:1609-1618. [PMID: 35881509 DOI: 10.1177/10556656221116001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Palate development involves a genetic regulation through a complex molecular mechanism that may be disrupted by environmental factors, resulting in impaired fusion and cleft palate formation. An encounter with a case of cleft palate due to dorsal tongue hamartoma prompted us to perform this systematic review. OBJECTIVE To review the clinical profile and management approach for a case with cleft palate and tongue hamartoma. DESIGN A systematic literature search was conducted using keywords related to cleft palate and tongue hamartoma in PubMed, Scopus, MEDLINE, and Scielo databases through December 2021, with no time or language restrictions. PATIENTS, PARTICIPANTS Studies reporting patients with cleft palate and tongue hamartoma were included. MAIN OUTCOME MEASURE(S) Information related to clinical profile, diagnostic tests, histopathology, management, and outcomes were extracted. Fourteen relevant publications were identified with 16 cases reported so far. Among them, thirteen patients were females (81.25%), and 3 were males (18.75%). The age of presentation varied from birth to 19 years. Oral-facial-digital syndrome (type II) was the most commonly associated syndrome. Congenital tongue hamartoma with cleft palate is a rare presentation, which can present as an isolated entity or part of a syndrome. Genetic evaluation is warranted, particularly for multiple hamartomatous lesions. The preferred treatment is immediate excision of hamartoma while following a standard timeline for palatoplasty.
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Affiliation(s)
- Suvashis Dash
- Department of Plastic Reconstructive & Burns Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank Chauhan
- Department of Plastic Reconstructive & Burns Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Karthik Sennimalai
- Department of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Om Prakash Kharbanda
- Department of Plastic Reconstructive & Burns Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Maneesh Singhal
- Department of Plastic Reconstructive & Burns Surgery, All India Institute of Medical Sciences, New Delhi, India
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21
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Pescia C, Pini G, Lopez G, Malfatto M, Brescia G, Tabano S, Del Gobbo A. A Rare Case of Urinary Bladder Hamartoma Clinically Mimicking an Urothelial Carcinoma: A Case Report and Review of the Literature. Int J Surg Pathol 2023; 31:1572-1579. [PMID: 36938586 PMCID: PMC10616991 DOI: 10.1177/10668969231159314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 03/21/2023]
Abstract
Urinary bladder hamartoma is a rare benign proliferation with only 14 cases reported in the literature at present. Urinary bladder hamartoma is composed of a disorderly admixture of normal urinary bladder components, essentially represented by glands lined by transitional epithelium and a variable percentage of fibrous stroma, smooth muscle bundles, and adipose tissue. Urinary bladder hamartomas do not exhibit cytological or architectural abnormalities and show no necrosis or increase in mitotic activity. Clinical manifestations are usually represented by lower urinary tract symptoms, more or less frequently paired with gross hematuria. Several pediatric cases of urinary bladder hamartoma have been reported, sometimes with syndromic associations. Transurethral resection has been curative in all cases reported, with no evidence of recurrence. Here we report an additional rare urinary bladder hamartoma, clinically mimicking urothelial carcinoma, providing a review of the literature regarding this unusual entity.
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Affiliation(s)
- Carlo Pescia
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuditta Pini
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Lopez
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Malfatto
- Division of Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gloria Brescia
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Silvia Tabano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Molecular Genetics Laboratory, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Del Gobbo
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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22
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Jenkin A, Cao AMY, Moloney J. Surgical polypectomy for small bowel hamartomas in Peutz-Jegher syndrome. ANZ J Surg 2023; 93:2997-2998. [PMID: 37553843 DOI: 10.1111/ans.18654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Affiliation(s)
- Ashley Jenkin
- Colorectal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | | | - Jayson Moloney
- Colorectal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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23
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Rizzi M, Nichelatti M, Ferri L, Consales A, De Benedictis A, Cossu M. Seizure outcomes and safety profiles of surgical options for epilepsy associated to hypothalamic hamartomas. A systematic review and meta-analysis. Epilepsy Res 2023; 198:107261. [PMID: 38006630 DOI: 10.1016/j.eplepsyres.2023.107261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE Several surgical options are available for treating hypothalamic hamartoma-related epilepsy but their respective efficacy and safety profiles are poorly defined. METHODS A literature search identified English-language articles reporting series of patients (minimum 3 patients with a follow-up ≥12 months) operated on by either microsurgery, endoscopic surgery, radiosurgery, radiofrequency thermocoagulation or laser interstitial thermal therapy for hypothalamic hamartoma-related epilepsy. The unit of analysis was each selected study. Pooled rates of seizure freedom and of neurological and endocrinological complications were analyzed using meta-analysis to calculate both fixed and random effects. The results of meta-analyses were compared. RESULTS Thirty-nine studies were included. There were 568 and 514 participants for seizure outcome and complication analyses, respectively. The pairwise comparison showed that: i) the proportion of seizure-free cases was significantly lower for radiosurgery as compared to microsurgery, radiofrequency thermocoagulation and laser ablation, and significantly lower for endoscopic surgery as compared to radiofrequency thermocoagulation; ii) the proportion of permanent hypothalamic dysfunction was significantly higher for microsurgery as compared to all other techniques, and significantly lower for endoscopic surgery as compared to radiofrequency thermocoagulation and laser ablation; iii) the incidence of permanent neurological disorders was significantly higher for microsurgery as compared to endoscopic surgery, radiosurgery and radiofrequency thermocoagulation, and significantly lower for radiosurgery as compared to laser ablation. CONCLUSIONS Minimally invasive surgical techniques, including endoscopic surgery, radiofrequency thermocoagulation and laser ablation, represent an acceptable compromise between efficacy and safety in the treatment of hypothalamic hamartoma-related epilepsy. Microsurgery and radiosurgery should be considered in carefully selected cases.
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Affiliation(s)
- Michele Rizzi
- Functional Neurosurgery Unit and Epilepsy Surgery Program, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy.
| | - Michele Nichelatti
- Service of Biostatistics, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Alessandro De Benedictis
- Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Massimo Cossu
- Neurosurgery Unit, Giannina Gaslini Pediatric Hospital IRCCS, Genoa, Italy
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24
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Paolantonio G, Cirillo M, Grussu F, Giancristoforo S, Bascetta S, Parapatt GK, Rollo M, Tomà P. Fibrolipomatous hamartoma of the median nerve in a child with carpal tunnel syndrome: imaging findings and literature review. J Ultrasound 2023; 26:913-918. [PMID: 36418537 PMCID: PMC10632239 DOI: 10.1007/s40477-022-00741-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
Fibrolipomatous hamartoma of the median nerve is an uncommon benign tumour of the childhood, which usually manifests in adolescents or adulthood with signs of compressive neuropathy at wrist. Symptomatic tumour is unusual in children below 5 years age and can be underdiagnosed. Magnetic resonance imaging provides pathognomonic features for the diagnosis, obviating the need for biopsy. Although standard ultrasonography is frequently the first-line imaging approach in the evaluation of soft-tissue masses, sonographic findings of this lesion are less frequently reported and have to be kept in mind by radiologist. We report the unusual case of carpal tunnel syndrome secondary to fibrolipomatous hamartoma of the median nerve in a 4-year-old child successfully treated with surgical carpal tunnel release.
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Affiliation(s)
- Guglielmo Paolantonio
- Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy.
| | - Marco Cirillo
- Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Grussu
- Plastic and Maxillofacial Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simona Giancristoforo
- Dermatology Unit and Genodermatosis Unit, Genetics and Rare Disease Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Bascetta
- Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - George Koshy Parapatt
- Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy
| | - Massimo Rollo
- Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy
| | - Paolo Tomà
- Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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25
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Farrugia Y, Pace Bardon M, Galea G, Micallef J. Tracheal hamartoma masquerading as asthma. BMJ Case Rep 2023; 16:e255267. [PMID: 38035684 PMCID: PMC10689378 DOI: 10.1136/bcr-2023-255267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
We present a rare case of a female non-smoker diagnosed with a large benign tracheal chondrohamartoma, masquerading as severe asthma. The patient was in her late 70s and had a history of asthma. She had presented to hospital with multiple episodes of intractable cough, shortness of breath and wheeze in the year prior to diagnosis. She had been managed for asthma for two decades by different physicians in primary care, based on documented airflow obstruction. Given her repeated admissions, the respiratory team was consulted. In view of the persistent cough despite maximal treatment, she was referred for a thoracic high-resolution CT scan which revealed a large intraluminal tracheal polypoid mass. Flexible bronchoscopy was performed and this confirmed the presence of a large pedunculated mass in the distal trachea. The patient subsequently underwent removal of the mass by means of rigid bronchoscopy, laser and electrocautery followed by argon ablation of residual tissue. She made an excellent recovery with full resolution of her respiratory symptoms and normalisation of her pulmonary function tests.
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Affiliation(s)
| | | | - Gabriel Galea
- Medical Imaging Department, Mater Dei Hospital, Msida, Malta
| | - Josef Micallef
- Department of Medicine, Respiratory Division, Mater Dei Hospital, Msida, Malta
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26
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Paraschou K, Miller B, Surda P, Sandison A. Nasal chondromesenchymal hamartoma (NCMH): a rare DICER1-associated tumour in an adult male. BMJ Case Rep 2023; 16:e254457. [PMID: 37967930 PMCID: PMC10660983 DOI: 10.1136/bcr-2022-254457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
An adult male presented to the ENT clinic with a 1-year history of unilateral nasal blockage. He had presented to another institution 5 years previously with the same issue, undergoing resection of what was reported to be a benign inflammatory polyp with osseous metaplasia. Detailed examination revealed a large mass filling the left nasal cavity. Excisional biopsy and secondary specialist review of pathology revealed nasal chondromesenchymal hamartoma (NCMH) with associated DICER1 mutations. NCMH is a rare, benign tumour of the sinonasal tract, presenting more often in the early childhood, with symptoms related to the site and extent of the tumour. As highlighted in this case, complete excision is mandatory for definitive diagnosis and treatment of NCMH, and an awareness of the association with DICER1 mutation, which can predispose individuals to a range of neoplasia, is key to providing appropriate genetic counselling.
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Affiliation(s)
| | | | - Pavol Surda
- ENT, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ann Sandison
- Head and Neck / Oral Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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27
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D'Oliveiro JLJ, Chong AW. Nasopharyngeal Respiratory Epithelial Adenomatoid Hamartoma-Master of Masquerade. Ann Otol Rhinol Laryngol 2023; 132:1483-1486. [PMID: 36941748 DOI: 10.1177/00034894231159325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To highlight a case of nasopharyngeal Respiratory Epithelial Adenomatoid Hamartoma (REAH) in a female patient with chronic nasal block. METHODS A single case report of a female patient with the diagnosis of REAH, detailing her presenting symptoms, clinical findings, management and follow up. RESULTS Histopathological assessment of the excised nasopharyngeal polyp was consistent with a diagnosis of REAH with a discussion on the disease and its current literature reviews. CONCLUSION The incidence of REAH within the nasopharynx remain rare with only few cases described in literature, especially in females.
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Affiliation(s)
| | - Aun Wee Chong
- Department of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia
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Reid B, Panesar D, Coutts R. Splenic hamartoma: laparoscopic assisted extracorporeal splenorrhaphy. ANZ J Surg 2023; 93:2770-2771. [PMID: 37553854 DOI: 10.1111/ans.18650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Affiliation(s)
- Benjamin Reid
- Department of Surgery, Palmerston North Hospital, Palmerston North, New Zealand
| | - Divyansh Panesar
- Department of Surgery, Palmerston North Hospital, Palmerston North, New Zealand
| | - Richard Coutts
- Department of Surgery, Palmerston North Hospital, Palmerston North, New Zealand
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29
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Zaldivar JKD, Bautista E, Gagto JO. Chest wall and nasal chondromesenchymal hamartoma in a toddler: treated during a global pandemic. BMJ Case Rep 2023; 16:e252019. [PMID: 37879704 PMCID: PMC10603396 DOI: 10.1136/bcr-2022-252019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/27/2023] Open
Abstract
We report an extremely rare case of a synchronous left chest wall and left maxillary sinus chondromesenchymal hamartoma in a toddler female. Although the lesions appeared malignant on imaging, they were benign by biopsy. The enlarging left anterior chest wall mass was surgically resected to prevent cardiovascular compression. The significant chest wall defect was reconstructed using the bird-cage technique with overlying pectoralis major muscle flap and native skin. The lesions at the left posterior rib and left maxillary sinus were closely observed. This case is the first reported synchronous chest wall and maxillary sinus chondromesenchymal hamartoma.
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Affiliation(s)
| | - Eduardo Bautista
- Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, Philippines
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Ahn S, Lee H, Kang JK, Kim IS, Moon Y, Choi JS, Choi SY. Large mesenchymal cystic and chondroid pulmonary hamartoma mimicking lung cancer: Case report. J Cardiothorac Surg 2023; 18:278. [PMID: 37817244 PMCID: PMC10563264 DOI: 10.1186/s13019-023-02394-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023] Open
Abstract
Pulmonary hamartoma is the most commonly resected benign neoplasm of lung. The mesenchymal cystic subtype is a rare and often bilaterally occurring variant composed of multiple cysts and nodules. Herein, we present an asymptomatic 70-year-old woman with a large and mostly cystic growth of right hilar region. Computed tomography of the chest and fluorodeoxyglucose positron emission tomography/computed tomography imaging traced its origins to right middle lobe. Overall features suggested primary lung cancer or perhaps other cystic lung disease.Because transbronchial lung biopsy failed to establish a histologic diagnosis, right middle lobectomy was undertaken by video-assisted thoracoscopic surgery. The gross surgical specimen harbored a single and sizeable (8.0 × 4.0 cm) cystic lesion containing multiple yellow-white nodules. A diagnosis of mesenchymal cystic and chondroid hamartoma was ultimately rendered. This particular case is noteworthy, given the initial clinical resemblance to primary lung cancer.
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Affiliation(s)
- Seha Ahn
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Heejin Lee
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Joon Kyu Kang
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - In Sub Kim
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Youngkyu Moon
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Jung Suk Choi
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Si Young Choi
- Department of Thoracic & Cardiovascular Surgery. Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea.
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Turpin J, Lehner KR, O'Donnell DB, D'Amico RS, Rodgers S, Langer DJ. Cranio-Orbitozygomatic Craniotomy for Resection of a Giant Hypothalamic Hamartoma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2023; 25:e225. [PMID: 37366622 DOI: 10.1227/ons.0000000000000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/24/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
- Justin Turpin
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Kurt R Lehner
- Department of Neurosurgery, Johns Hopkins Medicine Department of Neurology and Neurosurgery, Baltimore, Maryland, USA
| | - Devon B O'Donnell
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Randy S D'Amico
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Shaun Rodgers
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - David J Langer
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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32
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Sayegh Y, Tang V, Khzam RA, Rosenberg AE, Blessing N, Dubovy S. Presentation of a Smooth Muscle Hamartoma in the Bulbar Conjunctiva of an Adolescent Boy: A Case Report and Review of Literature. Cornea 2023; 42:1176-1178. [PMID: 37267468 PMCID: PMC10524459 DOI: 10.1097/ico.0000000000003314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/14/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this study was to describe a novel presentation of conjunctival smooth muscle hamartoma and review the histopathologic findings of this entity. METHODS A 17-year-old African American adolescent boy presented with a pink, nontender lesion of the right bulbar conjunctiva that did not improve with medical management. He had no previous medical or ocular history. The lesion was excised. RESULTS Histopathologic examination disclosed morphologically benign smooth muscle bundles within the substantia propria that stained positively for smooth muscle actin, vimentin, and desmin consistent with the diagnosis of a smooth muscle hamartoma. CONCLUSIONS Although congenital smooth muscle hamartomas of the conjunctiva have been rarely reported in the literature, this is the first described case of a smooth muscle hamartoma presenting in adolescence in the bulbar conjunctiva. This lesion should be considered in the differential diagnosis for adolescents with similar appearing lesions.
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Affiliation(s)
- Yoseph Sayegh
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Vincent Tang
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Rayan Abou Khzam
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Andrew E Rosenberg
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Nathan Blessing
- Oculofacial Plastic & Reconstructive Surgery, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and
| | - Sander Dubovy
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
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Fernández-Eire P, Betancor-Santos MA, Zulaica Garate A, Concheiro Guisan A. Neurocristic Cutaneous Hamartoma and Mohs Surgery in Pediatric Patients. Actas Dermosifiliogr 2023; 114:740-742. [PMID: 35513034 DOI: 10.1016/j.ad.2022.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/13/2022] [Accepted: 02/27/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- P Fernández-Eire
- Unidad de Cirugía Pediátrica, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España.
| | - M A Betancor-Santos
- Servicio de Anatomía Patológica, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - A Zulaica Garate
- Servicio de Dermatología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - A Concheiro Guisan
- Servicio de Pediatría, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España
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Hahne O, Rydenhag B, Tranberg AE, Kristjánsdóttir R, Nilsson D, Olsson I, Hallböök T. Epilepsy surgery in patients with hypothalamic hamartomas - Population-based two-year and long-term outcomes. Eur J Paediatr Neurol 2023; 46:24-29. [PMID: 37385151 DOI: 10.1016/j.ejpn.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 04/30/2023] [Accepted: 06/16/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Hypothalamic hamartomas are benign lesions associated with drug resistant epilepsy. Surgical treatment has become an increasingly utilised approach with promising results. This study aims to evaluate seizure outcome and complications after surgery in a population-based series of patients with intractable epilepsy and hypothalamic hamartoma. METHODS All patients with hypothalamic hamartoma treated with epilepsy surgery in Sweden since 1995 with at least two years of follow-up were included. Preoperative, two-, five- and ten-year prospective longitudinal data were collected from The Swedish National Epilepsy Surgery Register. Data included seizure types and frequency, duration of epilepsy, clinical characteristics, neurological deficits, cognitive level and complications. In a subgroup from Gothenburg, we also analysed data not included in the register such as classification of hamartomas, surgical procedures and gelastic seizures. RESULTS Eighteen patients were operated on during the period 1995-2020. The median age at epilepsy onset was 6 months and age at surgery 13 years. Four were seizure free and another four had ≥75% reduction in seizure frequency at the two-year follow-up. Two of the 13 patients with a long-term follow-up (five or ten years) were seizure-free and four had ≥75% reduction in seizure frequency. Three had an increased seizure frequency. No major complications were seen. Five had minor complications. In the Gothenburg subgroup all had open pterional disconnection or intraventricular endoscopic disconnection. Six of 12 were free from gelastic seizures at the two-year follow-up and six of eight at the long-term follow-up. CONCLUSION This study supports surgical treatment of hypothalamic hamartomas as a safe method with a low risk of permanent complications. The seizure reduction seems to be persistent over time.
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Affiliation(s)
- Oscar Hahne
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden.
| | - Bertil Rydenhag
- Member of the ERN, EpiCARE, Gothenburg, Sweden; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Anna Edelvik Tranberg
- Member of the ERN, EpiCARE, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Ragnhildur Kristjánsdóttir
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden; Habilitation & Health, Gothenburg, Sweden.
| | - Daniel Nilsson
- Member of the ERN, EpiCARE, Gothenburg, Sweden; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Ingrid Olsson
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden.
| | - Tove Hallböök
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Member of the ERN, EpiCARE, Gothenburg, Sweden.
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Kai K, Ide T, Tanaka T, Yukimoto K, Irie H, Noshiro H, Aishima S. A Case of Multicystic Biliary Hamartoma with a Marked Peribiliary Gland Component Successfully Treated by Purely Laparoscopic Anatomical Liver Resection. J Gastrointest Cancer 2023; 54:996-999. [PMID: 36449146 PMCID: PMC10613131 DOI: 10.1007/s12029-022-00893-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Multicystic biliary hamartoma (MCBH) is an extremely rare benign liver lesion characterized by a gross well-circumscribed multicystic honeycomb appearance. This report presents a MCBH case with a marked peribiliary gland component which showed unusual histology. CASE PRESENTATION A 63-year-old Japanese male was admitted to our hospital for a detailed examination of a hepatic cystic lesion, which was originally detected 14 years ago and had slowly enlarged. A preoperative imaging study revealed a well-demarcated multicystic lesion without communication to the biliary tracts. The possible clinical diagnoses were mucinous cystic neoplasm (MCN) or MCBH. The lesion was successfully resected by purely laparoscopic right anterior sectionectomy. The cut surfaces of resected specimens grossly exhibited a well-circumscribed multicystic lesion with a thick septum. Histologically, the cyst wall was covered by cuboidal epithelial cells resembling epithelium of the bile duct while abundant small ducts, which morphologically resembled peribiliary glands, were observed among the fibrous stroma of the thick septum. Although possible pathological diagnosis varied, including intrahepatic cholangiocarcinoma, intraductal papillary neoplasm of the bile duct, biliary adenofibroma, MCN and MCBH, the lesion was finally diagnosed as MCBH with a marked peribiliary gland component. CONCLUSIONS MCBH can contain abundant peribiliary glands in the fibrous stroma. A pathologist should be careful not to diagnose such peribiliary glands in MCBH as neoplastic glands.
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Affiliation(s)
- Keita Kai
- Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga, 849-8501, Japan.
| | - Takao Ide
- Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tomokazu Tanaka
- Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Kumpei Yukimoto
- Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroyuki Irie
- Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan
| | - Hirokazu Noshiro
- Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Shinichi Aishima
- Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga, 849-8501, Japan
- Departments of Pathology & Microbiology, Faculty of Medicine, Saga University, Saga, Japan
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Kulkarni N, Nageotte RA, Klamer BG, Rekate HL, Bristol RE, Scharnweber T, Bobrowitz M, Kerrigan JF. Long term outcome after surgical treatment for hypothalamic hamartoma. Epilepsy Res 2023; 195:107186. [PMID: 37454523 DOI: 10.1016/j.eplepsyres.2023.107186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/03/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To determine long-term outcome for seizure control and clinical predictors for seizure freedom in patients undergoing surgical treatment for epilepsy associated with hypothalamic hamartoma (HH). METHODS 155 patients underwent surgical treatment for HHs and treatment-resistant epilepsy at one center (Barrow Neurological Institute at St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA) between February 2003 and June 2010. Data collection included medical record review and direct follow-up interviews to determine seizure outcome. Statistical analysis included descriptive summaries of patient characteristics and time-to-event analysis for seizure freedom. RESULTS Long-term survival with follow-up of at least five years since first surgical treatment was available for 108 patients (69.7% of the treatment cohort). The surgical approach for first HH intervention consisted of transventricular endoscopic resection (n = 57; 52.8%), transcallosal interforniceal resection (n = 35; 32.4%), pterional resection (n = 7; 6.5%), and gamma knife radiosurgery (n = 9; 8.3%). Multiple surgical procedures were required for 39 patients (36.1%). There were 10 known deaths from all causes in the treatment cohort (6.5%). Of these, one (0.6%) was related to immediate complications of HH surgery, three (1.9%) were attributed to Sudden Unexpected Death in Epileptic Persons (SUDEP), and one (0.6%) to complications of status epilepticus. For surviving patients with long-term follow-up, 55 (50.9%) were seizure-free for all seizure types. Univariable analysis showed that seizure-freedom was related to 1) absence of a pre-operative history for central precocious puberty (p = 0.01), and 2) higher percentage of HH lesion disconnection after surgery (p = 0.047). Kaplan-Meier survival analysis shows that long-term seizure outcome following HH surgery is comparable to short-term results. SUMMARY These uncontrolled observational results show that long-term seizure control following HH surgical treatment is comparable to other forms of epilepsy surgery. Late relapse (at least one year after surgery) and SUDEP do occur, but in a relatively small number of treated patients. These results inform clinical practice and serve as a comparable benchmark for newer technologies for HH surgery, such as magnetic resonance imaging-guided laser interstitial thermal therapy, where long-term outcome results are not yet available.
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Affiliation(s)
- Neil Kulkarni
- Division of Pediatric Neurology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Rachel Ayn Nageotte
- Department of Family Medicine, HonorHealth Scottsdale Osborn Medical Center, Scottsdale, AZ, USA
| | - Brett G Klamer
- Biostatistics Resource at Nationwide Children's Hospital, Columbus, OH, USA; Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA
| | - Harold L Rekate
- Long Island Jewish Medical Center, North Shore University Hospital, The Chiari Institute, Manhasset, NY, USA
| | - Ruth E Bristol
- Division of Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Travis Scharnweber
- Department of Neuroradiology, Barrow Neurological Institute at St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Margaret Bobrowitz
- Department of Neurosurgery, Barrow Neurological Institute at St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - John F Kerrigan
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, University of Arizona College of Medicine, Phoenix, AZ, USA
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37
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Fernández-Eire P, Betancor-Santos MA, Zulaica Garate A, Concheiro Guisan A. [Translated article] Neurocristic Cutaneous Hamartoma and Mohs Surgery in Pediatric Patients. Actas Dermosifiliogr 2023; 114:T740-T742. [PMID: 37442421 DOI: 10.1016/j.ad.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/27/2022] [Indexed: 07/15/2023] Open
Affiliation(s)
- P Fernández-Eire
- Unidad de Cirugía Pediátrica, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
| | - M A Betancor-Santos
- Servicio de Anatomía Patológica, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - A Zulaica Garate
- Servicio de Dermatología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - A Concheiro Guisan
- Servicio de Pediatría, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
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38
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Rodrigo-Calvo M, Archilla I, Alos S, Vidal-Robau N, Saez de Gordoa K, Moreno J, Sendino O, Cuatrecasas M. Retrorectal hamartoma cyst (tailgut cyst) in a young man. Gastroenterol Hepatol 2023; 46:466-467. [PMID: 35718015 DOI: 10.1016/j.gastrohep.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 05/24/2023]
Affiliation(s)
- Maite Rodrigo-Calvo
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Ivan Archilla
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Silvia Alos
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nuria Vidal-Robau
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Karmele Saez de Gordoa
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Julián Moreno
- Radiology Department, Hospital Clínic, Barcelona, Spain
| | - Oriol Sendino
- Gastroenterology Department, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Universitat de Barcelona (UB), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - Miriam Cuatrecasas
- Department of Pathology, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Universitat de Barcelona (UB), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.
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39
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张 汝, 夏 交, 张 淑, 田 昊, 马 有. [Clinical characteristics of nasal respiratory epithelial adenomatoid hamartoma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:338-343. [PMID: 37138394 PMCID: PMC10495779 DOI: 10.13201/j.issn.2096-7993.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Indexed: 05/05/2023]
Abstract
〓 Objectives: To analyze the pathological and clinical features of nasal respiratory epithelial adenomatoid hamartoma(REAH), and summarize the diagnostic points, to improve the experience of diagnosis and treatment. Methods:The clinical data of 16 patients with REAH were analyzed retrospectively. The clinical manifestations, pathological features, imaging features, surgical treatment and prognosis were summarized. Results:16 cases of REAH were studied, 10 cases(62.50%) were associated with sinusitis, 1 case(6.25%) was associated with inverted papilloma, 1 case(6.25%) was associated with hemangioma. 5 cases(31.25%) had a history of nasal sinus surgery, including 1 case with 3 times of nasal sinus surgery, 1 case with 2 times of nasal sinus surgery, 3 cases with 1 time of nasal sinus surgery; 10 cases(62.50%) occurred in the bilateral olfactory cleft, 2 cases(12.50%) in the unilateral olfactory cleft, 3 cases(18.75%) in the unilateral middle turbinate, 1 case(6.25%) in the nasopharynx. All 16 patients were pathologically diagnosed as REAH. In the patients with lesions located in bilateral olfactory fissures, symmetrical widening of olfactory fissures and lateral displacement of middle turbinate were observed on preoperative sinus CT. The average width of bilateral olfactory fissures was (9.9±2.70) mm. The ratio of wide to narrow olfactory cleft was 1.21 ± 0.19. There was no significant difference in Lund-Mackay score between the two sides(P>0.05). All patients underwent surgery under general anesthesia and nasal endoscopy. The follow-up period ranged from 1 to 66 months, and no recurrence occurred. Conclusion:Preoperative diagnosis of REAH is facilitated by the combination of clinical manifestations and endoscopic and imaging features. Endoscopic complete resection can achieve a good therapeutic effect.
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Affiliation(s)
- 汝祥 张
- 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京,100050)Department of Otolaryngology Head and Neck Surgery, Beijing Friendship of Hospital, Capital Medical University, Beijing, 100050, China
| | - 交 夏
- 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京,100050)Department of Otolaryngology Head and Neck Surgery, Beijing Friendship of Hospital, Capital Medical University, Beijing, 100050, China
| | - 淑红 张
- 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京,100050)Department of Otolaryngology Head and Neck Surgery, Beijing Friendship of Hospital, Capital Medical University, Beijing, 100050, China
| | - 昊 田
- 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京,100050)Department of Otolaryngology Head and Neck Surgery, Beijing Friendship of Hospital, Capital Medical University, Beijing, 100050, China
| | - 有祥 马
- 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京,100050)Department of Otolaryngology Head and Neck Surgery, Beijing Friendship of Hospital, Capital Medical University, Beijing, 100050, China
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Bravo-Taxa M, Berrospi-Espinoza F, Taxa-Rojas L. [Pancreatic lipomatous hamartoma: A case report and literature review]. Rev Gastroenterol Peru 2023; 43:161-165. [PMID: 37597233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
Pancreatic hamartomas (PH) are extremely unusual non-neoplastic tumor-like lesions and accounts for <1% of all hamartomas. Moreover, there is a distinct variant of PH denominated Pancreatic lipomatous hamartoma (PLH), that is even rarer, with only 5 cases, including the present case, reported in the literature. PLH lacks well-defined features and clinically can be mistaken with other lipomatous lesions of the pancreas, including lipoma, pancreatic lipomatosis, PEComa, liposarcoma, and malignant tumors with lipomatous components. Here, we describe a case of PLH in a 70-year-old male with abdominal pain and a lesion, which was preoperatively diagnosed as a pancreatic no functional low-grade neuroendocrine tumor, and subsequent underwent a laparoscopic enucleation of the tumor. The postoperative pathology and immunohistochemical analyses confirmed the diagnosis of PLH.
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Affiliation(s)
- Mercedes Bravo-Taxa
- Departamento de Patología; Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú; Departamento de Patología; Laboratorio Oncológico Taxa (LOT), Lima, Perú
| | - Francisco Berrospi-Espinoza
- Departamento de Cirugía Digestiva; Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú; Departamento de Cirugía; Clínica Detecta, Lima, Perú
| | - Luis Taxa-Rojas
- Departamento de Patología; Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú; Departamento de Patología; Laboratorio Oncológico Taxa (LOT), Lima, Perú; Docente e investigador. Universidad de San Martín de Porres, Lima, Perú
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Rodriguez-Guzman F, Ruas JN, Cabral JGGDAL, Micelli-Neto O, Venco FE, Ardengh JC. CHRONIC ANEMIA CAUSED BY GIANT AND SOLITARY PEUTZ-JEGHERS HAMARTOMATOUS POLYP TREATED BY ENDOSCOPIC RESECTION. Arq Gastroenterol 2023; 60:282-284. [PMID: 37556755 DOI: 10.1590/s0004-2803.20230222-155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 08/11/2023]
Abstract
•Giant and solitary polyps evolve with anemia. •EUS is an important tool for stage and manage this disease. •Endoscopic treatment is the best treatment choice. •Supplementary video available on this case report.
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Affiliation(s)
| | | | | | | | - Filadelfio Euclides Venco
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Patología, São Paulo, SP, Brasil
| | - José Celso Ardengh
- Hospital Moriah, Serviço de Endoscopia Digestiva, São Paulo, SP, Brasil
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, SP, Brasil
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Han YP, Min CC, Li YB, Chen YQ, Liu H, Tian ZB, Yin XY. Diagnosis and treatment of gastric hamartomatous inverted polyp (GHIP) by endoscopic submucosal dissection: A case report. Medicine (Baltimore) 2023; 102:e33443. [PMID: 37000057 PMCID: PMC10063260 DOI: 10.1097/md.0000000000033443] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
RATIONALE Gastric hamartomatous inverted polyps (GHIP) is not a common disease, and it has rarely been reported in the literature. Preoperative diagnosis is difficult due to the deep position and surface covered with normal gastric mucosa. However, with the progress of endoscopic technology, endoscopic submucosal dissection (ESD) can play a crucial role in the diagnosis and treatment of GHIP. PATIENT CONCERNS A 61-year-old Chinese man underwent gastroscopy due to abdominal pain 2 months prior that revealed chronic superficial nonatrophic gastritis with erosion and a submucosal tumor in the gastric body (an ultrasound gastroscopy was recommended). Therefore, he was admitted to our hospital for further diagnosis and treatment. DIAGNOSES A hemispherical submucosal tumor was found in the middle segment of the stomach, with a size of approximately 30 mm × 35 mm and a smooth surface without central ulceration or mucosal bridge formation. Ultrasound gastroscopy showed that the lesion was a hypoechoic mass with uniform internal echo originating from the muscularis propria. INTERVENTIONS The tumor was completely removed by using ESD. The postoperative pathological results indicated a monocystic structure in the submucosa that was not connected with the surface mucosa. The surface of the cyst was covered with foveolar cells and mucous-neck cells (part of which had low-grade intraepithelial neoplasia), and GHIP was considered to be diagnosed. OUTCOMES According to the abovementioned endoscopic and pathological features, the patient was finally diagnosed with GHIP. The patient was successfully discharged after surgery and received regular follow-up observations. LESSONS GHIP is located in the submucosa layer and has the potential risk of malignant transformation. However, it is not easy to diagnose by using gastroscopy and ultrasound gastroscopy. ESD can obtain complete specimens, which contributes to the diagnosis and treatment of GHIP.
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Affiliation(s)
- Yi-Ping Han
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Cong-Cong Min
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Yu-Bei Li
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Yun-Qing Chen
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Hua Liu
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Zi-Bin Tian
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Xiao-Yan Yin
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
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Hou JZ, Dong NN, Yue B, Meng FD, Wang YJ. Autoimmune gastritis with a gastric hamartomatous inverted polyp and two hyperplastic polyps: a case report. J Int Med Res 2023; 51:3000605231162451. [PMID: 36967703 PMCID: PMC10052490 DOI: 10.1177/03000605231162451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
We report an unusual case of autoimmune gastritis (AIG) complicated with a submucosal tumor (SMT) and two pedunculated polyps in a 60-year-old man. The patient was admitted for epigastric distention, heartburn, and anorexia. Endoscopy showed an SMT in the fundus, two pedunculated polyps in the body, and markedly atrophic mucosa of the body and fundus. The SMT, measuring 20 mm in diameter, was resected by endoscopic submucosal dissection and histologically diagnosed as a gastric hamartomatous inverted polyp (GHIP), which is characterized by submucosal glandular proliferation, cystic dilatation, and calcification. The gland structures consisted of foveolar cells and pseudopyloric or mucous-neck cell types. The two pedunculated polyps that were resected by endoscopic mucosal resection were histologically diagnosed as hyperplastic polyps, which are characterized by hyperplastic foveolar glands with pseudopyloric or mucous-neck glands in the inflamed stroma in the mucosa, which consisted of almost the same types of lining cells as the GHIP in the fundus. Findings may indicate the relationship between GHIP, hyperplastic polyp, and AIG. We highlight considering GHIP as a differential diagnosis for an SMT in patients with AIG.
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Affiliation(s)
- Jun-Zhen Hou
- Department of Gastroenterology, Shijingshan teaching hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China
| | - Ning-Ning Dong
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
| | - Bing Yue
- Department of Pathology, Beijing Friendship Hospital of Capital Medical University, Beijing, China
| | - Fan-Dong Meng
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
| | - Yong-Jun Wang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
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Wei Z, Vodovotz L, Luy DD, Deng H, Niranjan A, Lunsford LD. Stereotactic radiosurgery as the initial management option for small-volume hypothalamic hamartomas with intractable epilepsy: a 35-year institutional experience and systematic review. J Neurosurg Pediatr 2023; 31:52-60. [PMID: 36272114 DOI: 10.3171/2022.9.peds22200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Young patients with hypothalamic hamartomas (HHs) often present with intractable epilepsy. Currently there are no established management guidelines for HH. The authors retrospectively reviewed their single-institution experience to delineate the role of stereotactic radiosurgery (SRS). METHODS Seven patients with HHs (4 females; median age 13.7 years, range 2.5-25 years) with no prior resection underwent SRS between 1987 and 2022. The clinical history, epilepsy profile, radiographic findings, and neurological outcomes were characterized. HH topographical types were classified according to the Régis classification. Outcome measures included Engel seizure classification, HH response, and the need for additional surgical interventions. RESULTS All patients had Engel class IV epilepsy. A Leksell Gamma Knife was used to deliver a median margin dose of 18 Gy (range 16-20 Gy) to a median hamartoma volume of 0.37 cm3 (range 0.20-0.89 cm3). Seizure reduction was confirmed in 6 patients, and 2 patients had regression of their hamartoma. Two patients underwent resection and/or laser interstitial thermal therapy after SRS. At follow-up, 1 patient was seizure free, 4 patients achieved Engel class II, 1 patient had Engel class III, and 1 patient had Engel class IV seizure outcomes. CONCLUSIONS SRS as the initial management option for HH was associated with a low risk of adverse effects. In this institutional series reviewing small-volume HHs treated with SRS, no adverse radiation effect was detected, and the majority of patients experienced seizure reduction. SRS should be considered as the first-line treatment for seizure control in patients with small-volume HHs.
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Affiliation(s)
- Zhishuo Wei
- 1School of Medicine, University of Pittsburgh Medical Center
- 2Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center; and
| | - Lena Vodovotz
- 1School of Medicine, University of Pittsburgh Medical Center
- 2Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center; and
| | - Diego D Luy
- 1School of Medicine, University of Pittsburgh Medical Center
- 2Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center; and
| | - Hansen Deng
- 2Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center; and
- 4Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ajay Niranjan
- 2Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center; and
- 4Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - L Dade Lunsford
- 2Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center; and
- 4Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Veselski Krajinović K, Stojadinović T, Pajić Matić I, Matić I, Sekelj A, Mahovne I, Marcikić M, Rotim K. RARE LARYNGEAL HAMARTOMA: A CASE REPORT. Acta Clin Croat 2022; 61:741-744. [PMID: 37868186 PMCID: PMC10588397 DOI: 10.20471/acc.2022.61.04.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 11/10/2021] [Indexed: 10/24/2023] Open
Abstract
Hamartoma (from the Greek language, where hamartia means defect or an error and -oma denoting a tumor or neoplasm) is a benign tumor-like mass composed of mature tissue or cells that are present in abnormal proportions or show a disorganized arrangement. Hamartomas are rarely seen in the head and neck area and especially rare in the larynx. Only few cases of laryngeal hamartoma have been reported in the literature so far. They are usually manifested by stridor, dysphonia and symptoms associated with airway obstruction. The diagnosis must be confirmed histologically and the method of choice in treatment is complete excision of the lesion. The authors present a case of laryngeal hamartoma of a 43-year-old woman treated for hoarseness and paralysis of the left vocal cord.
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Affiliation(s)
| | | | - Ivana Pajić Matić
- ENT Department, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
- Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
| | - Ivo Matić
- Department of Anesthesia and Resuscitation, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
- Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
| | - Alen Sekelj
- ENT Department, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Ivana Mahovne
- Department of Pathology and Cytology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Marcel Marcikić
- Department of Surgery, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Krešimir Rotim
- Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
- Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
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Hoshino T, Yoshizawa M, Ishida H. [Endobronchial Lipomatous Hamartoma Extended beyond a Bronchial Wall:Report of a Case]. Kyobu Geka 2022; 75:983-986. [PMID: 36176261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Pulmonary hamartomas are common benign lung tumors. Most cases are parenchymal chondromatous hamartomas, whereas endobronchial lipomatous hamartomas are rarely encountered. A 78-year-old man was referred for left superior subsegmental atelectasis due to obstruction by an endobronchial tumor that was found incidentally on chest computed tomography for the postoperative follow-up of colon cancer. Bronchoscopy showed a polypoid tumor in the orifice of the left upper segmental bronchus. Lipoma was diagnosed by a bronchoscopic biopsy. We performed a segmentectomy of the upper division of the left lung because the tumor was presumed to be located peripherally to the left B3 segmental bronchus. A histopathological examination revealed that the tumor was an endobronchial lipomatous hamartoma that extended to the pulmonary parenchyma beyond the bronchial wall.
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Affiliation(s)
- Taiki Hoshino
- Department of Thoracic Surgery, Kyoto Okamoto Memorial Hospital, Kyoto, Japan
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Takure AO, Okolo CA. Outcome and surgical management of symptomatic renal angiomyolipoma in Ibadan, Nigeria, Sub-Saharan Africa. Niger J Clin Pract 2022; 25:1624-1628. [PMID: 36308230 DOI: 10.4103/njcp.njcp_63_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Renal angiomyolipoma is the commonest benign solid kidney neoplasm though rare in clinical practice. The advent of radiological imaging techniques, refinement in surgical approach and techniques and availability of mammalian target of rapamycin have improved the outcome in these cohort of patients. AIM To report our experience with the surgical management of renal angiomyolipoma in the sub-Saharan Africa. PATIENTS AND METHODS This was a retrospective review of the records in the operating theatre book of urology division of patients who underwent radical nephrectomy over a 7-year-period (January 2013 to December 2019). The histologically confirmed renal angiomyolipoma information were retrieved from the records in the Department of Pathology. The clinical data were obtained from the patients' case files by identifying the patient with their registration number and not their names. The clinical features, investigations done, treatment offered, and the outcome of management were recorded in an SPSS version 20. The data was analyzed using statistics of central tendency and percentage. RESULTS Only 3 females with symptomatic renal angiomyolipoma were managed. This represented 4.9% of 61 patients with solid renal masses managed in the study period. The mean age was 51.2 (ranged 40-70) years. The mean tumor size was 18.9 cm. All the patients underwent radical nephrectomy. The pre- and postoperative urea and creatinine remained normal. The median follow-up period was 21 (16.5-30) months and were asymptomatic. CONCLUSION The incidence of renal angiomyolipoma among solid renal masses is 4.9% in our environment. Open radical nephrectomy is still the preferred method of treatment with satisfactory outcome.
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Affiliation(s)
- A O Takure
- Department of Surgery, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - C A Okolo
- Department of Pathology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Grigoraş A, Amălinei C, Lovin CS, Grigoraş CC, Pricope DL, Costin CA, Chiseliţă IR, Crişan-Dabija RA. The clinicopathological challenges of symptomatic and incidental pulmonary hamartomas diagnosis. Rom J Morphol Embryol 2022; 63:607-613. [PMID: 36808195 PMCID: PMC10028331 DOI: 10.47162/rjme.63.4.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Pulmonary hamartomas (PHs) are the most common benign lung tumors. Usually, they are asymptomatic and incidentally discovered during assessment for other diseases or during the autopsy exam. In this context, we have performed a retrospective analysis of surgical resections in a 5-year series of patients diagnosed with PHs in the Clinic of Pulmonary Diseases, Iaşi, Romania, aiming to evaluate their clinicopathological features. A total of 27 patients with PH (40.74% males and 59.26% females) were evaluated. 33.33% of patients were asymptomatic, while the others exhibited variable symptoms, such as chronic cough, dyspnea, chest pain or weight loss. In most cases, PHs presented as solitary nodules, predominantly disposed in the right upper lobe (40.74% of cases), followed by the right lower lobe (33.34%), and left lower lobe (18.51%). The microscopic examination revealed a mixture of mature mesenchymal tissue, such as hyaline cartilage, adipose tissue, fibromyxoid tissue, and smooth muscle bundles, in variable proportions, associated with clefts of entrapped benign epithelium. A dominant adipose tissue component was observed in one case. PH was associated with a history of extrapulmonary cancer diagnosis, in one patient. Although considered benign lung tumors, PHs diagnosis and therapy may be challenging. Having in mind the possibility of recurrence or their occurrence as a part of specific syndromes, PHs should be thoroughly investigated for an appropriate patients' management. Their complex significance and the correlation with other types of lesions, including malignancies, may be further studied, by more extensive studies of surgical and necroptic cases.
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Affiliation(s)
- Adriana Grigoraş
- Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania; ; ,
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Philip TJ, Patel NA, Gonzalez E. Combined Hamartoma of the Retina and Retinal Pigment Epithelium in a Patient With Fragile X Syndrome. J Pediatr Ophthalmol Strabismus 2022; 59:e39-e41. [PMID: 35856427 DOI: 10.3928/01913913-20220511-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 13-year-old boy with fragile X syndrome presented with painless, decreased vision in his right eye. Funduscopy revealed fibrotic tissue and an epiretinal membrane. This patient with fragile X syndrome was diagnosed as having combined hamartoma of the retina and retinal pigment epithelium and treated with vitrectomy and epiretinal membrane peeling. [J Pediatr Ophthalmol Strabismus. 2022;59(4):e39-e41.].
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Abstract
The spleen is a complex organ involved in multiple physiological processes in the human body. Elective splenectomy is an uncommon operation, and the precise characterization of the lesion should be achieved to determine the risks and benefits of this operation accurately. Given the significant role of the spleen in homeostasis and the potential risks of the surgery itself and following sequelae such as infection susceptibility, accurate recognition, and classification of splenic lesions is required before surgery. This review provides an overview of malignant (e.g., lymphoma, angiosarcoma) and benign (e.g., cysts, hemangioma, hamartoma) splenic lesions that may warrant an elective splenectomy. Images from a cohort of adult patients undergoing isolated splenectomy for non-traumatic indications in a single center are provided. This review highlights the considerable overlap in imaging patterns between splenic lesions, splenic lesions masquerading as lesions in other organs, increased detection of asymptomatic splenic incidentalomas due to improvements in imaging modalities. This review also provides clinical correlations for each lesion, providing additional information to help clinicians differentiate between lesions and accurately identify diseases amenable to surgical management.
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Affiliation(s)
| | - Hsien Min Low
- Department of Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Vishalkumar Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Cher Heng Tan
- Department of Radiology, Tan Tock Seng Hospital, Singapore, Singapore
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