Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child

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They are usually asymptomatic because of their small size and their slow-growing character. We report the case of a 5-year-old child presenting with a giant lung mass causing recurrent right pneumonia. Surgical resection with middle lobectomy was performed. Final histology revealed pulmonary hamartoma with predominant adenofibromatous and lipomatous differentiation." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-644", "name": "Case Report: Giant lung hamartoma : An usual cause of lobectomy in..." } } ] } Home Browse Case Report: Giant lung hamartoma : An usual cause of lobectomy in... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Louhaichi S, Hamdi B, Bouacida I et al. Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.12688/f1000research.146993.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Case Report Revised Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] Sabrine Louhaichi 1,2 , Besma Hamdi https://orcid.org/0000-0003-0343-7673 1,2 , Imen Bouacida 3 , [...] Yessmine Haddar 1,2 , Sarra Trimech 1,2 , Jamel Ammar 1,2 , Aida Ayadi 4 , Agnès Hamzaoui 1,2 , Baccouche Ines 5 , Adel Marghli https://orcid.org/0000-0002-9200-1478 3 Sabrine Louhaichi 1,2 , Besma Hamdi https://orcid.org/0000-0003-0343-7673 1,2 , [...] Imen Bouacida 3 , Yessmine Haddar 1,2 , Sarra Trimech 1,2 , Jamel Ammar 1,2 , Aida Ayadi 4 , Agnès Hamzaoui 1,2 , Baccouche Ines 5 , Adel Marghli https://orcid.org/0000-0002-9200-1478 3 PUBLISHED 24 Sep 2024 Author details Author details 1 Department of Respiratory Diseases B. Abderrahmen Mami Hospital, Ariana, Tunisia 2 Faculty of Medicine of Tunis, Laboratory Research 19SP02; Chronic Pathologies: From Genome to Management Tunis El Manar University, Tunis, Tunisia 3 Department of Thoracic and Cardiovascular Surgery Abderrahmen Mami Hospital, Ariana, Tunisia 4 Department of Pathology, Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia 5 Department of Radiology, Abderrahmen Mami Hospital, Ariana, Tunisia Sabrine Louhaichi Roles: Conceptualization, Data Curation, Investigation, Software, Writing – Original Draft Preparation, Writing – Review & Editing Besma Hamdi Roles: Conceptualization, Data Curation, Investigation, Writing – Original Draft Preparation, Writing – Review & Editing Imen Bouacida Roles: Data Curation, Investigation, Writing – Original Draft Preparation Yessmine Haddar Roles: Data Curation, Investigation, Writing – Original Draft Preparation Sarra Trimech Roles: Data Curation, Investigation Jamel Ammar Roles: Data Curation, Supervision, Validation Aida Ayadi Roles: Data Curation, Formal Analysis, Investigation, Supervision, Writing – Review & Editing Agnès Hamzaoui Roles: Investigation, Supervision, Validation, Writing – Review & Editing Baccouche Ines Roles: Formal Analysis, Supervision Adel Marghli Roles: Supervision OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Pulmonary hamartomas are the most common benign tumors of the lung in adults. They are usually asymptomatic because of their small size and their slow-growing character. We report the case of a 5-year-old child presenting with a giant lung mass causing recurrent right pneumonia. Surgical resection with middle lobectomy was performed. Final histology revealed pulmonary hamartoma with predominant adenofibromatous and lipomatous differentiation. READ ALL READ LESS Keywords lung tumor, case report, children, surgical intervention, hamartoma Corresponding Author(s) Sabrine Louhaichi ( [email protected] ) Close Corresponding author: Sabrine Louhaichi Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Louhaichi S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Louhaichi S, Hamdi B, Bouacida I et al. Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.12688/f1000research.146993.2 ) First published: 17 Jun 2024, 13 :644 ( https://doi.org/10.12688/f1000research.146993.1 ) Latest published: 24 Sep 2024, 13 :644 ( https://doi.org/10.12688/f1000research.146993.2 ) Revised Amendments from Version 1 More details related to surgery were added to give a clear and complete picture of the management of this benign tumor in children. More details related to surgery were added to give a clear and complete picture of the management of this benign tumor in children. To read any peer review reports and author responses for this article, follow the "read" links in the Open Peer Review table. READ REVIEWER RESPONSES Introduction Lung hamartomas are benign pulmonary tumors characterized by an incidental finding in most cases. 1 Compocased of a mixture of variant mesenchymal elements, it is more frequently seen in male adults. Pediatric cases are extremely rare. 2 , 3 Herein we report the case of a pulmonary hamartoma revealed by persistent pneumonia in a five-year-old child. Case report A five-year-old child was referred to our department in September 2023 because an abnormal pulmonary density of the lower right hemithorax. His past medical history revealed recurrent admissions for right pneumonia during the last two years. The patient complained of chronic productive cough without chest pain or hemoptysis. Physical examination did not reveal abnormalities apart from a decrease in breath sounds in the right lung. Chest radiography revealed a heterogeneous right opacity above the diaphragm as showed in Figure 1 . Figure 1. Chest radiograph view demonstrating a heterogeneous opacity in the middle and lower zones of the right lung. Chest computed tomography revealed a giant cystic and solid mass measuring 122 × 80 × 102 mm compressing the right middle and lower lobes. This mass contained tissular, fatty, and calcified elements, along with multiple airy cysts, suggesting a giant pulmonary hamartoma ( Figure 2 ). Figure 2. Pulmonary hamartoma: a contrast-enhanced lung CT scan is showing a large, lobulated soft-tissue density mass with foci of low attenuation and calcification with compression of the right lower lobe in mediastinal window (A) and lung window (B). Therapeutic options were discussed in a multidisciplinary reunion and surgery was decided. It was performed under general anaesthesia. The patient underwent a right lateral thoracotomy. During exploration, the mass occupied two-thirds of the right thorax and compressed the upper and lower lobes ( Figure 3 ) as well as the mediastinum. It was carefully mobilized. It doesn’t invade the mediastinum and the phrenic nerve was identified and preserved. The fatty mass depended on the middle lobe, which was a small strip of destroyed lung parenchyma. The surgical strategy was, to begin with an atypical resection removing the bloc of the mass followed by a complete right middle lobectomy. The dissection of the middle lobe arteries was challenging due to the destroyed tissue. The anatomical resection was successfully achieved and the patient was extubated immediately in the operating room. There were no anaesthetic complications during the procedure. The postoperative course was uneventful. The chest drain tube was removed three days postoperatively and the patient was discharged our days later. Figure 3. Resection of the tumor (A). The hamartoma after resection (B). The final histology of the tumor showed a well-circumscribed mass measuring 14 × 10 × 5 cm, with predominantly adenofibromatous and lipomatous differentiation, calcifications, and ossified lesions ( Figure 4 ). There was no evidence of cartilage or muscle tissue. The tumor was covered by a thin fibrous capsule. Additionally, diffuse alveolar hemorrhage lesions were observed in the middle lobe. Follow-up at three weeks post-surgery indicated no adverse outcomes. Figure 4. HE*40 Pulmonary hamartoma with adenofibromatous proliferation associated adipose tissue (A) Adenofibromatous pattern with cystic changes and club-like papillae set against a collagenous stroma (B). Discussion Pulmonary hamartomas are benign tumors that often occur in middle-aged adults with male predominance. 4 Within the pediatric population, pulmonary hamartomas are significantly rarer. 5 It is an incidental finding in most cases, with a diameter ranging from 1 to 8 cm. 6 This type of tumor has never been reported as a congenital lesion. Cytogenetic analysis showed abnormalities in chromosomal bands 6p21, 12q14–15, or other regions corresponding to mutations in high-mobility group (HMG) proteins. This group of proteins plays an important role in regulating chromatin architecture and gene expression. 7 The pathological pattern of the tumor usually shows predominant chondroid differentiation with a mixture of adipose tissue, fibrous tissue, smooth muscle, and bone, along with entrapped respiratory epithelium . Immunohistochemical staining is not necessary for the diagnosis. 8 In other cases, the major component can define various subtypes of the tumor: lipomatous, adenoleiomyomatous, and fibrous hamartomas. 7 , 9 In the current case, the tumor consisted histologically of glandular lumens and fibrous tissue with some calcifications. No evidence of cartilage or muscle tissue damage was observed. Pulmonary hamartomas are typically asymptomatic. The patient had a medical history of recurrent pneumonia before being referred to our department. Respiratory infections may occur because of mechanical obstruction of the bronchus. On tomodensitometry, lung hamartoma usually appears as a lobulated nodule with a heterogeneous density and no pleural traction. Characteristic imaging manifestations include the presence of fat (60% of the cases) and a popcorn appearance of calcifications observed in 5-50% of the cases. 10 Malignant transformation is exceedingly rare. 11 Surgery is indicated for symptomatic masses or those in which malignancy cannot be excluded. 12 , 13 Enucleation and wedge resection are the most common surgical choices for preserving functional lung tissue. 14 However, in our case, tumor resection and middle lobectomy were mandatory because of the large size of the tumor and compression of the surrounding parenchyma. Conclusions Lung hamartomas typically occur in adults and are asymptomatic in most cases; parenchymal resection is rarely required when surgery is indicated. Our case is unusual because of its many peculiarities. A 5-year-old child presented with recurrent pneumonia. Moreover, owing to its large size, the tumor caused parenchymal damage, leading to middle lobectomy during surgery. Finally, the tumor was characterized by predominant adenofibromatous differentiation, with no cartilage. Knowledge of atypical presentations of this neoplasm is crucial to avoid misdiagnosis and to guide appropriate surgical treatment, especially in pediatric patients. Consent Written informed consent was obtained from the patient’s parents for the publication of this case report and accompanying images. Data availability No data are associated with this article. References 1. Shukla I, Stead TS, Aleksandrovskiy I, et al. : Symptomatic Pulmonary Hamartoma. Cureus. 2021; 13 (9): e18230. PubMed Abstract | Publisher Full Text 2. Pouessel G, Thumerelle C, Santos C, et al. : Pulmonary hamartochondroma: a rare cause of solitary pulmonary nodule in children. J. Radiol. 2005; 86 : 79–82. PubMed Abstract | Publisher Full Text 3. Zapala MA, Ho-Fung VM, Lee EY: Thoracic Neoplasms in Children: Contemporary Perspectives and Imaging Assessment. Radiol. Clin. North Am. 2017; 55 (4): 657–676. Publisher Full Text 4. Grigoraş A, Amălinei C, Lovin CS, et al. : The clinicopathological challenges of symptomatic and incidental pulmonary hamartomas diagnosis. Romanian J. Morphol. Embryol. 2022; 63 (4): 607–613. PubMed Abstract | Publisher Full Text 5. Saadi MM, Barakeh DH, Husain S, et al. : Large multicystic pulmonary chondroid hamartoma in a child presenting as pneumothorax. Saudi Med. J. 2015; 36 (4): 487–489. PubMed Abstract | Publisher Full Text | Free Full Text 6. Ganti S, Milton R, Davidson L, et al. : Giant pulmonary hamartoma. J. Cardiothorac. Surg. 2006; 1 : 19. PubMed Abstract | Publisher Full Text | Free Full Text 7. Wick MR: Hamartomas and other tumor-like malformations of the lungs and heart. Semin. Diagn. Pathol. 2019; 36 (1): 2–10. PubMed Abstract | Publisher Full Text 8. Hashimoto H, Tsugeno Y, Sugita K, et al. : Mesenchymal tumors of the lung: diagnostic pathology, molecular pathogenesis, and identified biomarkers. J. Thorac. Dis. 2019; 11 (Suppl 1): S9–S24. PubMed Abstract | Publisher Full Text | Free Full Text 9. Wang S, Wei J, Yang K, et al. : Mesenchymal cystic hamartoma of the lung: a case report. Medicine. 2022; 101 (1): e28242–e28242. Publisher Full Text 10. Leiter Herrán F, Restrepo CS, Alvarez Gómez DI, et al. : Hamartomas from head to toe: an imaging overview. Br. J. Radiol. Mar 2017; 90 (1071): 20160607. PubMed Abstract | Publisher Full Text | Free Full Text 11. Chenkel R, Altfillisch C, Chung J, et al. : Malignant Degeneration of Biopsy-Proven Hamartoma to Chondrosarcoma. Cureus. 2020; 12 (12): e12150. PubMed Abstract | Publisher Full Text | Free Full Text 12. Elsayed H, Abdel Hady SM, Elbastawisy SE: Is resection necessary in biopsy-proven asymptomatic pulmonary hamartomas?. Interact. Cardiovasc. Thorac. Surg. 2015; 21 : 773–776. PubMed Abstract | Publisher Full Text 13. Erdogu V, Emetli EY, Kutluk AC, et al. : Does pulmonary hamartoma increase the risk of lung cancer? Outcomes of 38 pulmonary hamartoma cases. Sisli Etfal Hastan Tip Bul. 2021; 55 (3): 344–348–344–348. Publisher Full Text 14. Ulas AB, Aydin Y, Eroglu A: Pulmonary Hamartomas: A Single-Center Analysis of 59 Cases. Eur. J. Med. 2022; 54 (3): 270–273. Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 17 Jun 2024 ADD YOUR COMMENT Comment Author details Author details 1 Department of Respiratory Diseases B. Abderrahmen Mami Hospital, Ariana, Tunisia 2 Faculty of Medicine of Tunis, Laboratory Research 19SP02; Chronic Pathologies: From Genome to Management Tunis El Manar University, Tunis, Tunisia 3 Department of Thoracic and Cardiovascular Surgery Abderrahmen Mami Hospital, Ariana, Tunisia 4 Department of Pathology, Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia 5 Department of Radiology, Abderrahmen Mami Hospital, Ariana, Tunisia Sabrine Louhaichi Roles: Conceptualization, Data Curation, Investigation, Software, Writing – Original Draft Preparation, Writing – Review & Editing Besma Hamdi Roles: Conceptualization, Data Curation, Investigation, Writing – Original Draft Preparation, Writing – Review & Editing Imen Bouacida Roles: Data Curation, Investigation, Writing – Original Draft Preparation Yessmine Haddar Roles: Data Curation, Investigation, Writing – Original Draft Preparation Sarra Trimech Roles: Data Curation, Investigation Jamel Ammar Roles: Data Curation, Supervision, Validation Aida Ayadi Roles: Data Curation, Formal Analysis, Investigation, Supervision, Writing – Review & Editing Agnès Hamzaoui Roles: Investigation, Supervision, Validation, Writing – Review & Editing Baccouche Ines Roles: Formal Analysis, Supervision Adel Marghli Roles: Supervision Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 24 Sep 2024, 13:644 https://doi.org/10.12688/f1000research.146993.2 version 1 Published: 17 Jun 2024, 13:644 https://doi.org/10.12688/f1000research.146993.1 Copyright © 2024 Louhaichi S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Louhaichi S, Hamdi B, Bouacida I et al. Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.12688/f1000research.146993.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 24 Sep 2024 Revised Views 0 Cite How to cite this report: Özmen S. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.171972.r361907 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v2#referee-response-361907 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Mar 2025 Sevilay Özmen , Department of Pathology, Faculty of Medicine, Atatürk University, Erzurum, Turkey Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.171972.r361907 General Evaluation: This case report reports a rare presentation of a large pulmonary hamartoma in a pediatric patient. The article shows how the rare disease pulmonary hamartoma can present clinically in children. The authors have presented a successful case report ... Continue reading READ ALL General Evaluation: This case report reports a rare presentation of a large pulmonary hamartoma in a pediatric patient. The article shows how the rare disease pulmonary hamartoma can present clinically in children. The authors have presented a successful case report with detailed information about the patient's history of recurrent pneumonia, imaging modalities, and surgical intervention. The article also describes such a rare case in the literature and sheds light on the diagnostic and therapeutic processes of similar cases. The case highlights the atypical presentations of pulmonary hamartoma and how it may follow a different clinical course in pediatric patients. This may raise awareness in clinical practice. It was stated that genetic analysis should be performed in some pulmonary hamartoma cases and some chromosomal abnormalities were observed. However, genetic analysis was not performed for this case and it would be useful to provide more information in this section. “HMGA2 fusion in lung hamartomas suggests that these tumors share a similar pathogenesis with other mesenchymal tumors harboring HMGA2-related fusion genes (e.g., chondromas, extraskeletal osteochondromas, lipomas, and leiomyomas)” is stated in reference number 8. However, the source of information regarding molecular genetics is stated as number 7. This information needs to be corrected. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Pulmoner pathology, Hepatopankreato biliary pathology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Özmen S. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.171972.r361907 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v2#referee-response-361907 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Sezer HF. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.171972.r326621 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v2#referee-response-326621 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Nov 2024 Hüseyin Fatih Sezer , Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey Approved VIEWS 0 https://doi.org/10.5256/f1000research.171972.r326621 I reviewed the final ... Continue reading READ ALL I reviewed the final version of the article. Competing Interests: No competing interests were disclosed. Reviewer Expertise: The article is a repetition of what is generally known and has no additional features, except for some surgical difficulty. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sezer HF. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.171972.r326621 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v2#referee-response-326621 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 17 Jun 2024 Views 0 Cite How to cite this report: Nguyen DT and Nobleza KJ. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.161126.r317823 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v1#referee-response-317823 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 14 Sep 2024 Duc T Nguyen , Baylor College Medicine, Houston, Texas, USA Kenneth J. Nobleza , Baylor College of Medicine, Houston, Texas, USA Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.161126.r317823 Thank you for presenting this rare pulmonary hamartoma in children. Please find below a couple of comments you may want to consider for improving the manuscript: - More details regarding the surgery (pre-, intra-, and post-op) would be needed. ... Continue reading READ ALL Thank you for presenting this rare pulmonary hamartoma in children. Please find below a couple of comments you may want to consider for improving the manuscript: - More details regarding the surgery (pre-, intra-, and post-op) would be needed. - As the patient has got recurrent admission for right pneumonia for the past two years, serial results on chest radiography would be helpful. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Pediatrics We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Nguyen DT and Nobleza KJ. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.161126.r317823 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v1#referee-response-317823 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Sezer HF. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.161126.r294003 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v1#referee-response-294003 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 25 Jun 2024 Hüseyin Fatih Sezer , Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.161126.r294003 Dear Authors First of all, I would like to thank you for the work you have done to prepare the article. My criticisms and suggestions about the article are as follows. - The purpose of the article should ... Continue reading READ ALL Dear Authors First of all, I would like to thank you for the work you have done to prepare the article. My criticisms and suggestions about the article are as follows. - The purpose of the article should be written more clearly in the introduction, and some more literature information should be added. - The words 'case report, children, surgery' should be removed from keywords and more effective words should be added. - In the discussion section, pathology is included too much, is the article a surgery article or a pathology article? In addition, information about surgery should be added to the discussion (e.g. post-operative complications, postoperative results, etc.) and why anatomical resection is performed or in which cases it can be performed should be explained more clearly and comprehensively. -The conclusion section should be rewritten and unnecessary information should be removed. In addition, the discussion section should include the reasons why the case is considered unusual. Unfortunately, the article is a repetition of what is generally known and has no additional features, except for some surgical difficulty. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: The article is a repetition of what is generally known and has no additional features, except for some surgical difficulty. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sezer HF. Reviewer Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.161126.r294003 ) The direct URL for this report is: https://f1000research.com/articles/13-644/v1#referee-response-294003 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 17 Jun 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 2 (revision) 24 Sep 24 read read Version 1 17 Jun 24 read read Hüseyin Fatih Sezer , Kocaeli University Faculty of Medicine, Kocaeli, Turkey Duc T Nguyen , Baylor College Medicine, Houston, USA Kenneth J. Nobleza , Baylor College of Medicine, Houston, USA Sevilay Özmen , Atatürk University, Erzurum, Turkey Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Özmen S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Mar 2025 | for Version 2 Sevilay Özmen , Department of Pathology, Faculty of Medicine, Atatürk University, Erzurum, Turkey 0 Views copyright © 2025 Özmen S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions General Evaluation: This case report reports a rare presentation of a large pulmonary hamartoma in a pediatric patient. The article shows how the rare disease pulmonary hamartoma can present clinically in children. The authors have presented a successful case report with detailed information about the patient's history of recurrent pneumonia, imaging modalities, and surgical intervention. The article also describes such a rare case in the literature and sheds light on the diagnostic and therapeutic processes of similar cases. The case highlights the atypical presentations of pulmonary hamartoma and how it may follow a different clinical course in pediatric patients. This may raise awareness in clinical practice. It was stated that genetic analysis should be performed in some pulmonary hamartoma cases and some chromosomal abnormalities were observed. However, genetic analysis was not performed for this case and it would be useful to provide more information in this section. “HMGA2 fusion in lung hamartomas suggests that these tumors share a similar pathogenesis with other mesenchymal tumors harboring HMGA2-related fusion genes (e.g., chondromas, extraskeletal osteochondromas, lipomas, and leiomyomas)” is stated in reference number 8. However, the source of information regarding molecular genetics is stated as number 7. This information needs to be corrected. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Pulmoner pathology, Hepatopankreato biliary pathology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Özmen S. Peer Review Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.171972.r361907) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-644/v2#referee-response-361907 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Sezer H. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Nov 2024 | for Version 2 Hüseyin Fatih Sezer , Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey 0 Views copyright © 2024 Sezer H. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I reviewed the final version of the article. Competing Interests No competing interests were disclosed. Reviewer Expertise The article is a repetition of what is generally known and has no additional features, except for some surgical difficulty. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Sezer HF. Peer Review Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.171972.r326621) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-644/v2#referee-response-326621 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Nguyen D et al. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 14 Sep 2024 | for Version 1 Duc T Nguyen , Baylor College Medicine, Houston, Texas, USA Kenneth J. Nobleza , Baylor College of Medicine, Houston, Texas, USA 0 Views copyright © 2024 Nguyen D et al. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for presenting this rare pulmonary hamartoma in children. Please find below a couple of comments you may want to consider for improving the manuscript: - More details regarding the surgery (pre-, intra-, and post-op) would be needed. - As the patient has got recurrent admission for right pneumonia for the past two years, serial results on chest radiography would be helpful. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Pediatrics We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above. reply Respond to this report Responses (0) Nguyen DT and Nobleza KJ. Peer Review Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.161126.r317823) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-644/v1#referee-response-317823 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Sezer H. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 25 Jun 2024 | for Version 1 Hüseyin Fatih Sezer , Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey 0 Views copyright © 2024 Sezer H. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Dear Authors First of all, I would like to thank you for the work you have done to prepare the article. My criticisms and suggestions about the article are as follows. - The purpose of the article should be written more clearly in the introduction, and some more literature information should be added. - The words 'case report, children, surgery' should be removed from keywords and more effective words should be added. - In the discussion section, pathology is included too much, is the article a surgery article or a pathology article? In addition, information about surgery should be added to the discussion (e.g. post-operative complications, postoperative results, etc.) and why anatomical resection is performed or in which cases it can be performed should be explained more clearly and comprehensively. -The conclusion section should be rewritten and unnecessary information should be removed. In addition, the discussion section should include the reasons why the case is considered unusual. Unfortunately, the article is a repetition of what is generally known and has no additional features, except for some surgical difficulty. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise The article is a repetition of what is generally known and has no additional features, except for some surgical difficulty. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Sezer HF. Peer Review Report For: Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2024, 13 :644 ( https://doi.org/10.5256/f1000research.161126.r294003) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-644/v1#referee-response-294003 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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