Chondromesenchymal hamartomas in a 24-year-old male mimicking a posterior mediastinal tumor and a 5-month-old boy with postoperative disseminated intravascular coagulation: two case reports

Li, Yue1,2; Zheng, Danyang1,3; Zuo, Min4; Li, Yang5,6; Zhang, Huizhong1,3

2020-05-12

10.1186/s13000-020-00940-0

Diagnostic Pathology   影响因子和分区

1746-1596

1746-1596

Background Chondromesenchymal hamartoma of the chest wall is a rare, benign disease that usually presents at birth or in early infancy. It typically involves one or more ribs, forming a unilateral or bilateral extrapleural mass. Patients may be asymptomatic or complain of mild respiratory distress depending on tumor size and location. To the best of our knowledge, only two of the approximately 100 cases reported so far are adults. Case presentation We present two cases of chondromesenchymal hamartoma. The first case involved the left fifth rib in a 24-year-old male, in close proximity to the fifth vertebral body in the left posterior mediastinum, mimicking a posterior mediastinal tumor on imaging. The tumor was excised via thoracoscopy and the patient had an uneventful postoperative course. The second case was that of a 5-month-old boy, who had a tumor involving the left fifth and sixth ribs which caused thoracic cage collapse. Following en bloc resection of the tumor and the involved rib segments, the patient was transferred to the intensive care unit for treatment of pulmonary infection and disseminated intravascular coagulation (DIC). He was discharged from the hospital in stable condition 11 days later. On histopathology, the tumor was found to be a chondromesenchymal hamartoma with immature spindle-shaped mesenchymal cells, plate-like hyaline cartilage, areas of woven bone formation, endochondral ossification and calcification, osteoclastic giant cells, and secondary aneurysmal bone cysts. Conclusions Although the presently reported cases have morphological characteristics similar to previously reported ones, they had distinct radiological and clinical characteristics. Patient 1 is only the third report of an adult with chondromesenchymal hamartoma. His case was characterized by its radiological appearance mimicking a posterior mediastinal tumor. Patient 2 represents the first documentation of DIC as a postoperative complication following excision of a chondromesenchymal hamartoma. We present these two cases to provide clinicopathological insights regarding this extremely rare tumor that are relevant to both pathologists and clinicians.

Chondromesenchymal hamartoma Ribs Adult Infant Pathological diagnosis

SCI

英语

其他

Pathology

Pathology

WOS:000535890700001

BMC

Web of Science

1.Sun Yat Sen Univ, Ctr Canc, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangzhou 510060, Peoples R China
2.Sun Yat Sen Univ, Dept Mol Diagnost, Ctr Canc, Guangzhou 510060, Peoples R China
3.Sun Yat Sen Univ, Dept Pathol, Ctr Canc, Dongfeng Rd 651, Guangzhou 510060, Peoples R China
4.Southern Univ Sci & Technol, Affiliated Hosp 1, Dept Pathol, Clin Med Coll 2,Jinan Univ,Shenzhen Peoples Hosp, Shenzhen 518020, Peoples R China
5.Sun Yat Sen Univ, Affiliated Hosp 1, Dept Pathol, 58 Zhongshan Rd II, Guangzhou 510080, Peoples R China
6.Guangzhou Concord Canc Ctr, Dept Pathol, Guangzhou 510045, Peoples R China

Li, Yue,Zheng, Danyang,Zuo, Min,et al. Chondromesenchymal hamartomas in a 24-year-old male mimicking a posterior mediastinal tumor and a 5-month-old boy with postoperative disseminated intravascular coagulation: two case reports[J]. Diagnostic Pathology,2020,15(1).

Li, Yue,Zheng, Danyang,Zuo, Min,Li, Yang,&Zhang, Huizhong.(2020).Chondromesenchymal hamartomas in a 24-year-old male mimicking a posterior mediastinal tumor and a 5-month-old boy with postoperative disseminated intravascular coagulation: two case reports.Diagnostic Pathology,15(1).

Li, Yue,et al."Chondromesenchymal hamartomas in a 24-year-old male mimicking a posterior mediastinal tumor and a 5-month-old boy with postoperative disseminated intravascular coagulation: two case reports".Diagnostic Pathology 15.1(2020).