Percutaneous treatment of chest wall chondroid hamartomas: the experience of a single center.


Journal

Pediatric radiology
ISSN: 1432-1998
Titre abrégé: Pediatr Radiol
Pays: Germany
ID NLM: 0365332

Informations de publication

Date de publication:
02 2023
Historique:
received: 26 05 2022
accepted: 25 08 2022
revised: 28 07 2022
pubmed: 5 9 2022
medline: 4 2 2023
entrez: 4 9 2022
Statut: ppublish

Résumé

Thoracic mesenchymal hamartomas are rare benign lesions. Rarely symptomatic, they may compress pulmonary parenchyma, leading to respiratory distress. Although spontaneous regression has been documented, the more common outcome is progressive growth. The treatment of choice is en bloc excision of the involved portion of the chest wall, frequently leading to significant deformity. The aim of our study was to describe percutaneous techniques to treat these lesions. We collected data of children with thoracic mesenchymal hamartomas who were treated at our institution from 2005 to 2020 using various percutaneous techniques. Techniques included radiofrequency thermoablation, microwave thermoablation (microwave thermoablation) and cryoablation. Five children were treated for chest wall hamartomas; one child showed bilateral localization of the mass. Two children underwent microwave thermoablation, one radiofrequency thermoablation and two cryoablation; one child treated with cryoablation also had radiofrequency thermoablation because mass volume increased after the cryoablation procedure. The median reduction of tumor volume was 69.6% (24.0-96.5%). One child treated with microwave thermoablation showed volumetric increase of the mass and underwent surgical removal of the tumor. No major complication was reported. Percutaneous ablation is technically feasible for expert radiologists and might represent a valid and less invasive treatment for chest wall chondroid hamartoma, avoiding skeletal deformities.

Sections du résumé

BACKGROUND
Thoracic mesenchymal hamartomas are rare benign lesions. Rarely symptomatic, they may compress pulmonary parenchyma, leading to respiratory distress. Although spontaneous regression has been documented, the more common outcome is progressive growth. The treatment of choice is en bloc excision of the involved portion of the chest wall, frequently leading to significant deformity.
OBJECTIVE
The aim of our study was to describe percutaneous techniques to treat these lesions.
MATERIALS AND METHODS
We collected data of children with thoracic mesenchymal hamartomas who were treated at our institution from 2005 to 2020 using various percutaneous techniques. Techniques included radiofrequency thermoablation, microwave thermoablation (microwave thermoablation) and cryoablation.
RESULTS
Five children were treated for chest wall hamartomas; one child showed bilateral localization of the mass. Two children underwent microwave thermoablation, one radiofrequency thermoablation and two cryoablation; one child treated with cryoablation also had radiofrequency thermoablation because mass volume increased after the cryoablation procedure. The median reduction of tumor volume was 69.6% (24.0-96.5%). One child treated with microwave thermoablation showed volumetric increase of the mass and underwent surgical removal of the tumor. No major complication was reported.
CONCLUSION
Percutaneous ablation is technically feasible for expert radiologists and might represent a valid and less invasive treatment for chest wall chondroid hamartoma, avoiding skeletal deformities.

Identifiants

pubmed: 36058941
doi: 10.1007/s00247-022-05498-1
pii: 10.1007/s00247-022-05498-1
pmc: PMC9892089
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

249-255

Informations de copyright

© 2022. The Author(s).

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Auteurs

Alessandro Inserra (A)

General and Thoracic Surgery Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, RM, Italy.

Cristina Martucci (C)

General and Thoracic Surgery Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, RM, Italy. cristina.martucci@opbg.net.

Giulia Cassanelli (G)

Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Alessandro Crocoli (A)

Surgical Oncology Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Guglielmo Paolantonio (G)

Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Lorenzo M Gregori (LM)

Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Gian Luigi Natali (GL)

Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

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