Hamartoma surgery
|
Hamartoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hamartoma surgery On the Web |
|
American Roentgen Ray Society Images of Hamartoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Surgery is the mainstay for hamartomas.[1]
Surgery
Pulmonary Hamartoma
- Wedge resection is the main choice surgery for patients with pulmonary hamartoma.[1]
- Other interventions, such as: aggressive lobectomy or total pneumonectomy are only considered when the central intrapulmonary hamartoma is located in the deep part of pulmonary lobes or adhered severely to hilum, or/and the distal lung tissue is nonfunctional.
- Intraoperative frozen section is necessary to rule out malignancy.
Hypothalamic Hamartoma
- Hypothalamic hamartomas can be effectively treated with a variety of surgical approaches.
- The most effective approach is the magnetic resonance imaging (MRI)-guided stereotactic laser ablation (SLA).
- This approach offers a a potentially safer, minimally invasive method with high efficacy for the hypothalamic hamartoma treatment.[2]
- Other specific surgical options include; stereotactic thermocoagulation, gamma knife radiosurgery, and physical resection by transsphenoidal microsurgery.
- Surgery is normally offered if there is a rapid growth of lesion.
- Surgical response is typically better when the seizure focus has been found by EEG to originate in or near the mass.
- The specific location of the lesion relative to the pituitary and infundibulum and the amount of hormonal disturbance at presentation can help predict risk of hypopituitarism following surgery.[3]
Cardiac Hamartoma
- Complete surgical excision is the main choice surgery for symptomatic patients with cardiac hamartoma.
- Other intervention may be partial excision. However, this procedure is only indicated when the tumor size is more extensive.
- Postsurgical recurrence is rare. [4]
Kidneys, Spleen, and Other Vascular Organs Hamartomas
- Laparoscopic splenectomy is the standard procedure for most of benign and malignant splenic tumors.[5]
- Other tumors, such as angiomyolipomas do not normally require surgery unless there is life-threatening bleeding.
- Some centers may perform preventative selective embolisation of the angiomyolipoma if it is more than 4cm in diameter, due to the risk of hemorrhage.[6]
References
- ↑ 1.0 1.1 Guo W, Zhao YP, Jiang YG, Wang RW, Ma Z (2008). "Surgical treatment and outcome of pulmonary hamartoma: a retrospective study of 20-year experience". J. Exp. Clin. Cancer Res. 27: 8. doi:10.1186/1756-9966-27-8. PMC 2438336. PMID 18577258.
- ↑ Wilfong AA, Curry DJ (2013). "Hypothalamic hamartomas: optimal approach to clinical evaluation and diagnosis". Epilepsia. 54 Suppl 9: 109–14. doi:10.1111/epi.12454. PMID 24328883.
- ↑ Pascual-Castroviejo I, Moneo JH, Viaño J, García-Segura JM, Herguido MJ, Pascual Pascual SI (2000). "[Hypothalamic hamartomas: control of seizures after partial removal in one case]". Rev Neurol (in Spanish). 31 (2): 119–22. PMID 10951665.
- ↑ Bradshaw SH, Hendry P, Boodhwani M, Dennie C, Veinot JP (2011). "Left ventricular mesenchymal hamartoma, a new hamartoma of the heart". Cardiovasc. Pathol. 20 (5): 307–14. doi:10.1016/j.carpath.2010.07.007. PMID 20850353.
- ↑ Habermalz B, Sauerland S, Decker G, Delaitre B, Gigot JF, Leandros E, Lechner K, Rhodes M, Silecchia G, Szold A, Targarona E, Torelli P, Neugebauer E (2008). "Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)". Surg Endosc. 22 (4): 821–48. doi:10.1007/s00464-007-9735-5. PMID 18293036.
- ↑ Loffroy, R; Rao, P; Kwak, BK; Ota, S; De Lin, M; Liapi, E; Geschwind, JF (May–Jun 2010). "Transcatheter arterial [[embolization]] in patients with kidney diseases: an overview of the technical aspects and clinical indications" (PDF). Korean journal of radiology : official journal of the Korean Radiological Society. 11 (3): 257–68. doi:10.3348/kjr.2010.11.3.257. PMC 2864852. PMID 20461179. URL–wikilink conflict (help)