Medicine of the Future in America

Peripheral Intrapulmonary Hamartoma Accompanied by a Similar Endotracheal Lesion: Conclusion

Multiple pulmonary hamartomas, of which there are two varieties—leiomyomatous and chondromatous, are unusual. Furthermore, most of them are of the leiomyomatous type and occur almost exclusively in women with a history of leiomyomatous disease of the uterus. It has not, therefore, been clarified whether they are multiple leiomyomatous hamartomas or metastasized fibroleiomyomas of the uterus.

We have identified only 14 published case reports of multiple chondromatous hamartomas. Seven of them were in men and seven were in women. This stands in contrast to the female predominance in most reports of multiple leiomyomatous hamartomas. Seven cases were associated with gastric leiomyoblastoma, and one case had a coexisting fibroleiomyomatous hamartoma. No cases of malignant changes have been reported. Recurrence of lesions, however, occurred in two cases inhalers for asthma.
There is controversy about whether the histologic varieties of hamartomas represent separate entities or simply different morphologic expressions of the same process. This has been debated especially in relation to parenchymal and endobronchial tumors. In this present case, both lesions occurred in one person and had the same pathologic findings.

In the literature, Minasian reported the first case of endobronchial hamartoma accompanied by a similar in-trapulmonary hamartoma. Although our case did not have a bronchial lesion, but an endotracheal nodule, this is the second case of multiple hamartomas showing coexistence of tracheobronchial and parenchymal tumors. These cases might seem to support the view of Bateson that intrapul-monary and tracheobronchial chondromatous hamartomas are similar, the only difference being the site of origin and the direction of growth.

This present case did not receive any medical treatment for the tracheal hamartoma because of the lack of symptoms. Recently, however, endoscopic surgery has been recommended for a tracheal hamartoma, especially for symptomatic patients. Careful follow-up is required in this case.

This entry was posted in Pulmonary function and tagged bronchoscopy, chondromatous, leiomyomatous, tracheal hamartoma.
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