Thymolipoma - the frontier between hamartoma and neoplasia?

Benign lesions of the mediastinum

Mediastinal tumours represent a heterogeneous group of entities derived from the manifold structures located in or adjacent to the mediastinum. Due to the occurrence of some of these tumours in characteristic mediastinal compartments, an anatomical subdivision of the mediastinum in the prevascular (anterior), visceral (middle), and paravertebral (posterior) is helpful for the differential diagnosis. Benign anterior mediastinal tumours linked to an enlargement of the thymic gland mainly consist of thymic cysts and several types of thymic hyperplasia: true thymic hyperplasia, rebound hyperplasia, lymphofollicular hyperplasia, and so-called thymic hyperplasia with lymphoepithelial sialadenitis (LESA)-like features. Mature teratomas, ectopic (para)thyroid tissue, and benign thymic tumours such as thymolipoma or thymofibrolipoma represent further typical tumours of the anterior mediastinum. Pericardial, bronchogenic, or oesophageal duplication cysts predominate in the middle mediastinum, whereas neurogenic tumours and myelolipomas are characteristic findings in the posterior compartment. Vascular tumours, lipomas, adenomatoid tumours, Castleman disease, or mediastinitis are further examples of less frequent tumours or tumorous lesions affecting the mediastinum. This review focuses on benign mediastinal lesions with an emphasis on benign tumours of the thymus. Besides histology, characteristic epidemiological and clinical aspects prerequisite for the correct diagnosis and patient management are discussed.

Massive anterior mediastinal lipoma causing cardiac arrest in a middle-aged male: a case report and literature review

Lipoma is a common benign soft tissue tumor, but its size and location can lead to serious issues. We report a case of a 48 year-old male patient who experienced sudden cardiac arrest outside the hospital. After resuscitation and examination, we determined that this was due to a massive mediastinal lipoma compressing the lungs, leading to respiratory failure and pulmonary encephalopathy, ultimately resulting in cardiac arrest. This case serves as a reminder to promptly identify and manage chest lipomas to avoid compression and functional impairment of the respiratory system. Early evaluation and treatment of massive lipomas are crucial for preventing complications.

Posterior urethral hamartoma with hypospadias in a child: a case report and literature review

Background

Hamartoma is a mass formed by the proliferation and disorder of two or more kinds of cells inherent in normal organs or anatomical parts, which can occur in any part of the body. The most common hamartoma are kidney hamartoma, spleen hamartoma, liver hamartoma, and lung hamartoma. Urethral hamartoma is extremely rare in clinical practice.

Case report

Combined with literature review, the diagnosis and treatment process of a child with posterior urethral hamartoma and hypospadias in our hospital were analyzed. The patient was cured after surgical treatment, the lesion was completely removed, the appearance was satisfactory, and there was no recurrence, urethral stricture, urethral fistula, and other complications. The pathological results of this case support the histological diagnosis of hamartoma, which provides reference for the clinical diagnosis and treatment of congenital malformation and tumor of urogenital in children.

Conclusion

When a child has posterior urethral hamartoma, the symptoms may not be very typical, and it is often combined with urethral malformation. Therefore, it is necessary to perform careful physical examination combined with pathological examination to be able to make an accurate diagnosis. Under normal circumstances, the prognosis of urethral hamartoma is good. However, more cases are needed to be observed for verification, and a long-term effective follow-up after surgery is needed.