Puduru Nikhil, Ka Dilip Vasant, Shaikh Faiza A, Shaikh Humaira, Acharya Bimarsh, Sydhom Pishoy
Department of Surgery, SVS Medical College, Yenugonda.
Department of Surgery Shadan Institute of Medical Sciences and Research, Hyderabad, Telangana, India.
Ann Med Surg (Lond). 2024 Jul 1;86(9):5518-5522. doi: 10.1097/MS9.0000000000002339. eCollection 2024 Sep.
Hamartomas are abnormal growths that consist of various types of mesenchymal tissues, including cartilage, fat, connective tissue, and smooth muscle. These tumors can occur in almost any organ system within the body. While head and neck hamartomas have been frequently documented, cases involving the lower limbs are relatively rare. However, a unique instance of a mesenchymal hamartoma located in the leg has recently emerged.
A 30-year-old woman presented with a painless, gradually growing swelling on her left leg, diagnosed as a subcutaneous hemangioma preoperatively. Despite unsuccessful propranolol treatment, surgical excision revealed a mesenchymal hamartoma. Postoperative examination confirmed the diagnosis, and the patient recovered smoothly without recurrence after a week of hospitalization.
Cutaneous mesenchymal hamartomas are benign tissue growths with unknown etiology, associated with syndromes like Cowden and Peutz-Jeghers. Smooth muscle hamartoma can be acquired after skin trauma. Hemartoma can be misdiagnosed as hemangiomas. Cutaneous mesenchymal hamartomas presents as painless swellings in various locations, occasionally in adulthood. Differential diagnoses include lipomas and fibromas. Surgical excision is recommended for symptomatic cases to prevent recurrence.
This case highlights the atypical presentation of the hamartoma and emphasizes the importance of accurate diagnosis and management.
错构瘤是由各种间充质组织构成的异常生长物，包括软骨、脂肪、结缔组织和平滑肌。这些肿瘤几乎可发生于体内任何器官系统。虽然头颈部错构瘤已有频繁记录，但累及下肢的病例相对罕见。然而，最近出现了一例位于腿部的间充质错构瘤的独特病例。
一名30岁女性因左腿出现无痛性、逐渐增大的肿块就诊，术前诊断为皮下血管瘤。尽管普萘洛尔治疗失败，但手术切除显示为间充质错构瘤。术后检查确诊，患者住院一周后顺利康复，无复发。
皮肤间充质错构瘤是病因不明的良性组织增生，与考登综合征和佩-杰综合征等有关。平滑肌错构瘤可在皮肤创伤后获得。错构瘤可被误诊为血管瘤。皮肤间充质错构瘤表现为不同部位的无痛性肿块，偶尔在成年期出现。鉴别诊断包括脂肪瘤和纤维瘤。对于有症状的病例，建议手术切除以防止复发。
本病例突出了错构瘤的非典型表现，并强调了准确诊断和管理的重要性。
