What are the commonly used drugs for hamartoma

In recent years, due to the continuous improvement of medical detection methods, many diseases that were not easy to detect before can now be easily detected. Hamartoma is one of them. Generally, diseases are first treated with drugs, and then with surgery. Today, I will introduce to you the commonly used drugs for hamartoma.

The first choice for treating hamartoma is surgery. The effect of drug treatment is not obvious. Let me introduce the treatment methods separately:

1. Pulmonary Hamartoma

Most pulmonary hamartomas are benign, with malignancy accounting for only about 0.5%, but there are also reports of malignant transformation of pulmonary hamartomas in the literature. Because this part is sometimes difficult to distinguish from peripheral lung cancer, early surgery is often recommended. For middle-aged and elderly people with isolated lung lesions that cannot be confirmed to be benign, surgical exploration should be performed. Most cases of pulmonary hamartoma can be treated with tumor removal or wedge resection. If the tumor is located at the hilum of the lung, is huge, or is difficult to separate from the hilar bronchi and blood vessels, or has caused irreversible pathological changes in the distal lung tissue, lobectomy can be performed, and complete lung resection is rarely required. Whether it is tumor removal or lobectomy, there is no recurrence after surgery.

2. Renal Hamartoma

(1) Follow-up: Tumors <4 cm may not require treatment, but close follow-up is required.

(2) Arterial embolization should be considered first in cases of bleeding. According to experience, the volume of the tumor does not decrease after embolization, but the bleeding can be stopped. Superselective renal artery branch embolization is often used to protect some renal function.

(3) Nephron-sparing surgery: Tumors < 5 cm can be enucleated, especially those at the edge of the kidney.

(4) Nephrectomy: Giant renal hamartomas can be treated with nephrectomy. If the disease is bilateral, more consideration should be given to the preservation of renal function. In a few cases, there may be local and lymph node invasion, or even tumor thrombus invasion of large veins, showing malignant behavior, and radical nephrectomy should be performed.

(5) Kidney transplantation or hemodialysis is only suitable for patients who have bilateral nephrectomy due to renal failure caused by bilateral lesions or tumor rupture and bleeding.

3. Hepatic Hamartoma

Surgery is still the first choice for this disease. Because hamartomas are often clearly demarcated from normal liver tissue, tumor removal can be an option. If the tumor is tightly adhered to liver tissue, partial liver resection or liver lobectomy can be performed. Children's livers are mostly free of cirrhosis and have strong regenerative capacity, which provides conditions for extensive liver resection.

4. Hypothalamic hamartoma (HH)

(1) Drug treatment: HH is not a true tumor and grows slowly. The size of the lesion may remain unchanged for many years. Therefore, if it only manifests as a single symptom of precocious puberty, gonadotropin-releasing hormone analogues can be used to control it.

(2) Surgical resection The following patients may choose surgical treatment: those who are ineffective with drug treatment for precocious puberty; or those who are effective with treatment but develop neurological symptoms such as ataxia and epileptic seizures during medication; or those who are unable to afford the cost of drug treatment; those who are ineffective with gelastic epilepsy and other types of epilepsy; and those whose neurological dysfunction is caused by the mass effect of the tumor. The surgical procedures available include: pterional approach, transcallosal interforniceal approach, and neuroendoscopy. With the development of imaging and the improvement of microsurgical techniques, the complete resection rate of hypothalamic hamartomas has increased significantly, and good results have been achieved. After the complete resection of the hamartoma, the symptoms of precocious puberty stop and hormone levels return to normal. In some children, epileptic seizures completely stop or the number of seizures is significantly reduced.

(3) Other treatment methods Conventional radiotherapy is ineffective for HH. Gamma knife has a good effect on children with gelastic or grand mal seizures, with no mortality and low disability rate; it is theoretically effective for children with precocious puberty, but there is a lack of corresponding clinical data; it can be used as a good supplement for those with epilepsy as the main symptom and the difficulty of surgery or the inability to completely remove the tumor.

5. Breast Hamartoma

Breast hamartoma should be actively removed surgically, and the diagnosis should be confirmed by paraffin section. There is generally no recurrence after surgery and the prognosis is good.