Large multicystic pulmonary chondroid hamartoma in a child presenting as pneumothorax |
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| Authors: | Muslim M. Saadi Duna H. Barakeh Sufia Husain Waseem M. Hajjar |
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| Affiliation: | From the Departments of Pediatrics (Saadi), Thoracic Surgery (Barakeh, Hajjar), and Pathology (Husain), College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia |
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| Abstract: | We describe a 10-year-old boy with a rare large multicystic pulmonary chondroid hamartoma in the right lower lobe presenting with severe respiratory distress. The radiological evaluation showed a large multicystic lesion in the right lower lobe with pneumothorax. Commonly, pulmonary hamartomas are asymptomatic, small in size, and are diagnosed incidentally in adults. Our case is highly unusual due to its young age, prominent clinical symptoms of severe respiratory distress with pneumothorax at presentation, very large size, and prominent cystic change. The lesion was surgically excised, and histopathological features were compatible with a multicystic chondroid hamartoma.Hamartomas are an abnormal proliferation of a mixture of tissue elements that are normally present in that organ. Pulmonary hamartomas (PH), also known as chondroid hamartomas, are the most common benign tumors of the lung in adults.1 They are slow growing, non-infiltrative, and nodular. Histologically, they show a mixture of mature mesenchymal tissue like adipose tissue, cartilage, bone, smooth muscle bundles, and fibromyxoid tissue in varying proportions.2 In addition, cleft-like spaces lined by respiratory epithelium are common. Males are 4 times more affected than females. The PHs are common in the fifth and sixth decade of life, and they tend to occur in the peripheral lung fields. Radiologically, they are typically described as coin lesions due to their smooth, sharply demarcated outline, and round shape. Identification of ‘popcorn-like’ calcification on plain radiograph is diagnostic when present. The PHs are mostly asymptomatic, diagnosed incidentally, measuring less than 4 cms in diameter, and they rarely show extensive cyst formation. We report a case of a large multilocular cystic chondroid pulmonary hamartoma in a 10-year-old boy. Our objective in presenting this particular case is to highlight the highly unusual pediatric age group, unique clinical and radiological findings, prominent cystic change, and very large size. |
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