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Tracheal hamartoma: report of a child with a neck mass
E Gross1, M K Chen, R S Hollabaugh
1Section of Pediatric Surgery, LeBonheur Children's Hospital, University of Tennessee, Memphis, USA.
Insights
Tracheal hamartoma is rare in children. This case details the first pediatric extraluminal tracheal hamartoma presenting as a neck mass, successfully resected with no complications.
Area of Science:
- Pediatric Surgery
- Thoracic Pathology
- Medical Imaging
Background:
- Tracheal hamartomas are uncommon pediatric airway lesions.
- Previous cases primarily involved older adults with obstructive lung disease symptoms.
- Intraluminal tracheal hamartomas are exceptionally rare in children.
Observation:
- A 21-month-old girl presented with an anterior neck mass fixed to the trachea.
- Imaging revealed a calcified, mixed-density lesion anterior to the thyroid, extending to the trachea.
- Surgical exploration identified a firm, lobulated mass attached to the trachea.
Findings:
- Histological examination confirmed a tracheal hamartoma composed of mature cartilage, fat, fibroconnective tissue, and spindle cells.
- The lesion was completely resected.
- The patient experienced an unremarkable postoperative recovery.
Implications:
- This represents the first reported pediatric case of an extraluminal tracheal hamartoma presenting as a neck mass.
- Highlights the importance of considering rare diagnoses in pediatric neck masses.
- Successful surgical management of pediatric tracheal hamartoma is demonstrated.
Abstract:
Tracheal hamartoma represents an oddity in children. Only one case was found in the English literature as a distal tracheal intraluminal lesion causing obstructive symptoms. All other reported cases were in older patients, who were presumed to have asthma or chronic obstructive pulmonary disease. The authors report on a 21-month-old girl who presented with an anterior neck mass fixed to the trachea. Imaging studies showed a lesion (2.5 x 2.3 x 1.7 cm) anterior to the right lobe of the thyroid, extending to the trachea posteriorly and down to the thoracic inlet inferiorly. The mass had a mixture of soft tissue densities with a focus of calcification. Results of thyroid studies were normal, and there was no adenopathy. Neck exploration showed a white, firm, lobulated mass fixed to the trachea, which was resected completely. The postoperative course was unremarkable. Histological studies showed a mixture of mature cartilage, fat, fibroconnective tissue, and spindle cells with myxoid degeneration, consistent with tracheal hamartoma. Based on a literature search, this is the first reported case of extraluminal tracheal hamartoma presenting as a neck mass in a pediatric patient.