Hamartoma surgery: Difference between revisions
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==Overview== | |||
Surgical intervention is recommended for the management of hamartomas.<ref name="pmid18577258">{{cite journal |vauthors=Guo W, Zhao YP, Jiang YG, Wang RW, Ma Z |title=Surgical treatment and outcome of pulmonary hamartoma: a retrospective study of 20-year experience |journal=J. Exp. Clin. Cancer Res. |volume=27 |issue= |pages=8 |year=2008 |pmid=18577258 |pmc=2438336 |doi=10.1186/1756-9966-27-8 |url=}}</ref> | |||
==Surgery== | |||
===Pulmonary hamartoma=== | |||
Wedge resection is the main choice surgery for patients with pulmonary hamartoma.<ref name="pmid18577258">{{cite journal |vauthors=Guo W, Zhao YP, Jiang YG, Wang RW, Ma Z |title=Surgical treatment and outcome of pulmonary hamartoma: a retrospective study of 20-year experience |journal=J. Exp. Clin. Cancer Res. |volume=27 |issue= |pages=8 |year=2008 |pmid=18577258 |pmc=2438336 |doi=10.1186/1756-9966-27-8 |url=}}</ref> 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 of the lung 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 effectuve 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.<ref name="pmid24328883">{{cite journal |vauthors=Wilfong AA, Curry DJ |title=Hypothalamic hamartomas: optimal approach to clinical evaluation and diagnosis |journal=Epilepsia |volume=54 Suppl 9 |issue= |pages=109–14 |year=2013 |pmid=24328883 |doi=10.1111/epi.12454 |url=}}</ref> | |||
Other specific surgical options include; [[stereotactic]] thermocoagulation, [[gamma knife]] [[radiosurgery]], and physical resection by [[sphenoid bone|transsphenoidal]] microsurgery. | |||
Surgery is normally offered if there is failure of medical therapy or 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 [[pituitary stalk|infundibulum]] and the amount of hormonal disturbance at presentation can help predict risk of [[hypopituitarism]] following surgery.<ref>{{cite journal |author=Pascual-Castroviejo I, Moneo JH, Viaño J, García-Segura JM, Herguido MJ, Pascual Pascual SI |title=[Hypothalamic hamartomas: control of seizures after partial removal in one case] |language=Spanish|journal=Rev Neurol |volume=31 |issue=2 |pages=119–22 |year=2000 |pmid=10951665 }}</ref> | |||
===Cardiac hamartoma=== | |||
===Kidneys, spleen, and other vascular organs hamartomas=== | |||
==References== | ==References== | ||
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[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
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Revision as of 16:37, 8 January 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Surgical intervention is recommended for the management of 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 of the lung 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 effectuve 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 failure of medical therapy or 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
Kidneys, spleen, and other vascular organs hamartomas
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.