General and Thoracic Surgery Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, RM, Italy.
Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pediatr Radiol. 2023 Feb;53(2):249-255. doi: 10.1007/s00247-022-05498-1. Epub 2022 Sep 5.
Thoracic mesenchymal hamartomas are rare benign lesions. Rarely symptomatic, they may compress pulmonary parenchyma, leading to respiratory distress. Although spontaneous regression has been documented, the more common outcome is progressive growth. The treatment of choice is en bloc excision of the involved portion of the chest wall, frequently leading to significant deformity.
The aim of our study was to describe percutaneous techniques to treat these lesions.
We collected data of children with thoracic mesenchymal hamartomas who were treated at our institution from 2005 to 2020 using various percutaneous techniques. Techniques included radiofrequency thermoablation, microwave thermoablation (microwave thermoablation) and cryoablation.
Five children were treated for chest wall hamartomas; one child showed bilateral localization of the mass. Two children underwent microwave thermoablation, one radiofrequency thermoablation and two cryoablation; one child treated with cryoablation also had radiofrequency thermoablation because mass volume increased after the cryoablation procedure. The median reduction of tumor volume was 69.6% (24.0-96.5%). One child treated with microwave thermoablation showed volumetric increase of the mass and underwent surgical removal of the tumor. No major complication was reported.
Percutaneous ablation is technically feasible for expert radiologists and might represent a valid and less invasive treatment for chest wall chondroid hamartoma, avoiding skeletal deformities.
胸内间叶性错构瘤是一种罕见的良性病变。由于其症状罕见，可能会压迫肺实质，导致呼吸困难。虽然有自发性消退的记录，但更常见的结果是进行性生长。治疗的首选方法是整块切除受累的胸壁部分，这通常会导致明显的畸形。
我们的研究旨在描述治疗这些病变的经皮技术。
我们收集了 2005 年至 2020 年在我院接受各种经皮技术治疗的胸内间叶性错构瘤患儿的数据。这些技术包括射频热消融、微波热消融（微波热消融）和冷冻消融。
5 例患儿因胸壁错构瘤接受治疗；1 例患儿存在双侧病变。2 例患儿接受微波热消融，1 例患儿接受射频热消融，2 例患儿接受冷冻消融；1 例接受冷冻消融的患儿因冷冻消融后肿块体积增大而再次接受射频热消融。肿瘤体积中位数减少 69.6%（24.0-96.5%）。1 例接受微波热消融治疗的患儿肿块体积增加，接受了肿瘤切除术。未报告重大并发症。
对于有经验的放射科医生来说，经皮消融技术是可行的，并且可能是一种有效的、微创的治疗胸壁软骨样错构瘤的方法，可以避免骨骼畸形。
