Giant lipofibromatous hamartoma of median nerve in a child

Lipofibromatous hamartoma (LFH) is a rare fibrofatty tumor of adipocytes within peripheral nerves, affecting mainly children. It typically presents as a palpable mass surrounding the nerves of the upper limbs, causing pain and neurological deficits in the affected nerve distribution. We report the case of a child with a 2-years presentation of a mass in the right wrist associated with pain and paresthesia, who underwent investigation with magnetic resonance imaging (MRI). It showed thickening of the median nerve with spaghetti-like appearance associated with lipomatous tissue in a coaxial cable-like pattern, both features characteristic of LFH. This case illustrates the importance of MRI in the differential diagnosis of limb masses in the pediatric population.

Tailgut cyst - a case report

Retrorectal hamartoma, also called tailgut cyst, is a congenital lesion resulting from the non-regression of embryo remnants of the hindgut. We describe in this work the case report of a 68-year-old man, previously healthy, complaining of rectal bulging for 4 months, which was diagnosed by nuclear magnetic resonance imaging as a multi-loculated and mucinous lesion, suggestive of tailgut cyst. In view of the finding, the lesion was surgically resected, due to the potential for future complications, and, through the anatomopathological analysis, there were no findings of malignancy in the specimen. (AU)

Hamartoma fibroso de la infancia: reporte de caso / Fibrous hamartoma of infancy: a case report

Resumen: El hamartoma fibroso de la infancia (FHI) es una lesión rara de tejidos blandos en niños con morfología trifásica característica. El principal problema con estas lesiones es el diagnóstico diferencial con otras masas de tejidos blandos, en particular sarcomas, que requieren un afrontamiento clínico y terapéutico diferente. Presentamos un caso de un infante de 10 meses con un crecimiento asintomático de una masa axilar que, tras realizarse angioresonancia magnética y biopsia se confirmó el diagnóstico de FHI.

Abstract: Fibrous hamartomas of childhood (FHC) are rare soft tissue lesions in infants and young children with characteristic three-phase morphology.The main problem with these lesions is differentiating it from other soft tissue masses, in particular sarcomas, which require a different clinical and therapeutic approach. We present a case of a 10-month-old infant with asymptomatic growth of a left axillary mass that, after magnetic resonance angiography and biopsy, the diagnosis of FHC was confirmed.

Hamartoma mioide, serie de casos y revisión de la literatura / Myoid hamartoma: a case series and literature review

Abstract: Myoid hamartoma is a rare entity, and was first described by Davies and Riddell in 1973. It is pathologically defined as the mixture of fatty glandular tissue and fibrous connective tissue, associated with a widespread focus of fusiform muscle cells. Six cases of HM diagnosed in seven patients are presented, with emphasis on imaging findings and characteristics of their respective core biopsies. The importance of biopsy in these lesions is required to differentiate malignant diseases. There is no need for excisional biopsy, because this is not associated with high-risk lesions or carcinomas.

Resumen: El hamartoma mioide es una lesión infrecuente; fue descrita por primera vez por Davies y Riddell en el año 1973; se define histológicamente como la mezcla de tejido glandular adiposo y conjuntivo fibroso, asociado a extensos focos de células musculares fusiformes. Se presentan 7 casos de HM diagnosticados en 7 pacientes, haciendo énfasis en las características imagenológicas y los hallazgos de las respectivas biopsias core. La importancia de realizar biopsia en estas lesiones radica en la necesidad de diferenciarla de patologías malignas; así mismo no existe necesidad de biopsia excisional, ya que se trata de una entidad que no se asocia a lesiones de alto riesgo o con cáncer.

Diagnóstico en tomografía computarizada de tumores endobronquiales de estirpe lipomatosa / Computed tomography diagnosis of lipomatous endobronchial tumors lineage

We describe two cases of lipomatous endobronquial tumors diagnosed by CT. The first case showed a homogeneous fat density endobronquial nodule in the right intermediate bronchus compatible with lipoma. The second patient underwent a CT under the suspicion of a endobronquial lesion after two episodes of pneumonia localized in left lower lobe. The TC demonstrated a fat predominant nodule in the left lower lobe bronchus. The anatomopathologic study confirmed a lipomatous hamartoma with areas of mature cartilage.

. Describimos 2 casos de tumores lipomatosos endobronquiales diagnosticados mediante TC. El primer caso mostró un nódulo homogéneo de densidad grasa de 11 mm localizado en el bronquio intermediario derecho, que correspondió a un lipoma. El segundo paciente se sometió a una TC por la sospecha de lesión endobronquial luego que cursara con 2 episodios de neumonías localizadas en el lóbulo inferior izquierdo. En esta se demostró un nódulo de predominio graso con pequeñas áreas de densidad de partes blandas en el bronquio inferior izquierdo. El estudio patológico confirmó que se trataba de un hamartoma lipomatoso con áreas de cartílago maduro.

Hamartoma de la mama / Breast hamartoma

El hamartoma de la mama o fibroadenolipoma de la mama es una lesión nodular que puede simular un fibroadenoma o un tumor phyllodes. Aparece en las mujeres en la edad media de la vida y se presenta clínicamente como un nódulo bien definido e indoloro. El diagnóstico imagenológico es el que hace pensar en éste, ya que es un tumor poco frecuente. Histológicamente cumple los requisitos generales de un hamartoma: mezcla desordenada de tejidos maduros y especializados. En la mama se puede apreciar estructura ductal y lobulillar con estroma fibroso, tejido adiposo y en ocasiones, tejido muscular liso. En este trabajo se presenta un caso de una paciente de 40 años con un hamartoma de la mama derecha que histológicamente mostraba además, tejido óseo y cartilaginoso(AU)

Breast hamartoma or breast fibroadenolipoma is a nodular lesion that may resemble a fibroadenoma or phyllodes tumor. It appears in middle-aged women and it clinically presents as a well defined and painless nodule. The imaging diagnosis makes to think about it, since it is an uncommon tumor. From the histological point of view, it fulfills the general requirements of a hamartoma: disarranged combination of mature and specialized tissues. Ductal and lobular structure with fibrous stroma, fat tissue and, on occasions, smooth muscular tissue, may be observed in the breast. A case of a 40-year-old female patient with a hamartoma of the right mamma that histologically showed osteal and cartilaginous tissue is reported(AU)

Pulmonary chondroid hamartomas

The author reports a case of pulmonary chondroid hamartomas. This dysembryoplasic bone tumor has been diagnosed lately in a 37 year-old patient, reproduces pratically all the clinical, radiological symptoms and the therapeutical and diagnosis difficultes met in atypical and evolving forms of hamartoma in the litterature

Unusual Perirenal Location of a Tailgut Cyst

The authors describe a case in which a tailgut cyst occurred at an unusual location in a 22-year-old woman referred for abdominal discomfort and urinary frequency. The left abdomen contained a palpable mass, found at imaging studies to be a homogeneous, unilocular and cystic, and anterior to the left kidney. After surgical excision, it was shown to be a tailgut cyst.

Mesenchymal hamartomas of the chest wall in infancy: radiologic and pathologic correlation

Mesenchymal hamartoma of the chest wall is a rare tumor with about 53 reported cases in the English literature. We reviewed six chest wall mesenchymal hamartomas in four patients, including two cases with multiple lesions, with specific focus on the radiologic and pathologic correlation. All cases occurred in neonates or infants with ages ranging from seven hours to seven months. They were diagnosed with plain chest radiographs (n=6), ultrasonography (n=2), chest CT scan (n=6), whole body bone scan (n=2) and MRI (n=3). All cases except a small one without cystic change showed the typical features of mesenchymal hamartoma radiographically and pathologically. Radiologically they were well-circumscribed masses with solid and cystic components with multiple fluid-fluid levels in association with single or multiple rib destruction or change. The CT scan showed the typical findings of chest wall hamartoma, and the MR showed heterogeneous signal intensities of the mass on T1- and T2-weighted images. The MR also revealed more concisely a secondary aneurysmal bone cyst formation with multiple fluid-fluid levels on the T2-weighted image. Microscopically, they showed alternating areas of cartilaginous islands and primitive appearing mesenchymal proliferation, which corresponded well with the solid component on the radiologic findings. The areas of bone formation and blood-filled cystic spaces matched the calcified or ossified densities and the cystic components, respectively. A small case without cystic change showed peculiar radiological and pathological findings resembling an osteochondroma. In conclusion, mesenchymal hamartoma of the chest wall in infancy is quite rare and sometimes can be misdiagnosed as malignancy due to the bone-destroying radiographic appearance and the highly cellular and mitotically active microscopic features, unless the radiologists and pathologists are aware of the characteristic clinical, radiological, and pathological findings. Imaging studies can usually make a correct diagnosis with good correlation to the pathologic findings.

Solid mesenchymal hamartoma of the liver in adult

This paper presents an unusual solid mesenchymal hamartoma of the liver (MHL) in adult. A well defined solid mass in the left lobe of the liver was found in a 57-year-old female. Preoperative radiologic examinations demonstrated solid mass with multifocal calcifications abutting the gallbladder. By light microscopy, the lesion was composed of dense fibrous stroma with hyalinization, bile ducts and thick-walled vessels without hepatocytes. The solid and hyalinized mesenchymal component would suggest an unusual degenerative change representing a burnt-out MHL.