PULMONARY HAMARTOMAS

Objective: To analyze the clinical and pathologic features of biopsy-p roven pulmonary hamartomas at a tertiary referral center, Design: We r etrospectively reviewed institutional data on pulmonary hamartomas for a 17-year study period. Material and Methods: The Mayo Clinic compute rized medical records database was searched for patients who had biops y, excision, or autopsy diagnosis of pulmonary hamartomas from 1976 th rough 1992, Medical records and all available histologic sections were reviewed. Results: Of the 215 patients with histologically confirmed pulmonary hamartoma, 141 were men and 74 were women (approximately a 2 :1 ratio), Two hundred eight patients were asymptomatic, 54 of whom we re undergoing assessment for a comorbid disease process, Only four pat ients had new onset of respiratory symptoms, The peak incidence of occ urrence was in the seventh decade of life, The mean size of the hamart omas was 1.5 cm (range, 0.2 to 6.0); no lobe was predominantly involve d, Most hamartomas were resected by simple or wedge excision. Sixty-th ree patients (29.3%) had a concurrent neoplasm (most commonly, lung ca rcinoma), Follow-up ranged from 2 to 192 months (mean, 61), Eight post operative deaths occurred. No recurrent pulmonary hamartomas developed . In one patient, lung carcinoma developed 33 months after excision of a hamartoma. In a second patient, sputum cytologic findings were abno rmal 9 years later, A third patient had biopsy-proven adenocarcinoma m etastatic to bone and an indeterminate lung nodule 2 years after resec tion of a pulmonary hamartoma. Conclusion: Pulmonary hamartomas are be nign lung neoplasms that, in our referral population, occurred most co mmonly in asymptomatic older men, A substantial number of our patients had concurrent neoplasms; however, many had been referred for cancer treatment, We found no evidence of either a malignant transformation o r an unexplained association with other lung neoplasms.