From the Guidelines
Lung hamartomas are benign tumors that do not require further CT follow-up if they are smoothly marginated with internal fat and calcification, as evidenced by the 2017 Fleischner Society guidelines 1. When a lung hamartoma is identified, it is essential to consider its characteristics, such as size, location, and composition.
- Most lung hamartomas are small, well-circumscribed, and peripheral, appearing as solitary pulmonary nodules on chest imaging.
- They typically contain a mixture of tissues, including cartilage, fat, fibrous tissue, and sometimes bone.
- The presence of internal fat and calcification on CT images is highly suggestive of a hamartoma, as seen in Figure 1 of the 2017 Fleischner Society guidelines 1.
- For asymptomatic lung hamartomas with characteristic features, no further CT follow-up is recommended, according to the guidelines 1.
- However, larger hamartomas or those causing symptoms may require surgical removal, usually through a minimally invasive approach like video-assisted thoracoscopic surgery (VATS).
- Regular follow-up imaging may be advised for small, asymptomatic hamartomas to monitor for growth, although the risk of malignant transformation is very low.
- Lung hamartomas are more common in adults, particularly between ages 40-70, and occur more frequently in men than women, representing about 8% of all solitary pulmonary nodules 1.
From the Research
Definition and Diagnosis of Lung Hamartoma
- Lung hamartoma is the most common benign tumor of the lung, often presented as a solitary pulmonary nodule of peripheral localization 2, 3.
- Diagnosis can be achieved through computed tomography (CT) scan, bronchoscopy, and histopathological examination 2, 4.
Treatment Options for Lung Hamartoma
- Surgical resection is a common treatment option, with methods including tumor enucleation, wedge resection, and lobectomy 3, 5.
- Video-assisted thoracic surgery (VATS) is a recommended approach for patients with pulmonary hamartoma that cannot be confirmed preoperatively 5.
- Endoscopic cryosurgical resection is also a viable treatment option for endobronchial hamartoma 4.
- Complete resection of the tumor is curative, with no tumor recurrence reported in most cases 3, 5.
Clinical Presentation and Outcomes
- Patients with lung hamartoma may be asymptomatic or present with respiratory symptoms such as cough and dyspnea 3.
- The majority of pulmonary hamartomas are solitary and can be treated with minimal morbidity 3.
- Postoperative follow-up has shown no regional recurrence in most cases 5.
- Rare cases of concomitant giant pulmonary bulla and hamartoma have been reported, with successful treatment through VATS pulmonary wedge resection 6.