# Giant Anterior Mediastinal Hamartoma in a Middle-Aged Woman: A Rare Encounter

## TL;DR

A rare case of a large benign tumor in the chest of a middle-aged woman is presented, emphasizing the importance of considering non-cancerous tumors in unusual locations.

## Contribution

This case report adds to the limited literature on giant anterior mediastinal hamartomas and their diagnostic and treatment considerations.

## Key findings

- A 7.7 cm mediastinal hamartoma was diagnosed in a 53-year-old woman with endometrial carcinoma.
- Surgical excision was performed due to the tumor's size and compressive effects, resulting in a good postoperative recovery.
- Imaging features like fat density can suggest hamartoma, but histopathology is necessary for confirmation.

## Abstract

Hamartomas are benign neoplasms most commonly arising in the lung, typically identified as incidental solitary pulmonary nodules. Occurrence in the mediastinum is exceedingly rare. Because anterior mediastinal lesions are most often malignant, hamartomas in this location pose a diagnostic challenge.

We present the case of a 53-year-old female with a background of endometrial carcinoma who was evaluated for chest pain and palpitations. A chest radiograph revealed a large opacity in the left upper hemithorax, corresponding to a well-circumscribed anterior mediastinal mass on computed tomography. The lesion measured 7.7 × 7 × 7 cm, contained macroscopic fat, and partially compressed adjacent bronchovascular structures. A CT-guided biopsy demonstrated fibrous, cartilaginous, adipose, and bronchial elements without atypia, confirming the diagnosis of mediastinal hamartoma. Due to the lesion’s size and compressive effects, surgical excision was performed through a left exploratory thoracotomy. The patient recovered well postoperatively.

Mediastinal hamartomas are rare and can mimic more aggressive anterior mediastinal neoplasms. Imaging features such as fat density may suggest the diagnosis, but histopathology remains essential for confirmation. Surgical resection is indicated in symptomatic or compressive cases, and the prognosis following excision is excellent. This case highlights the importance of considering benign entities such as hamartoma in the differential diagnosis of anterior mediastinal masses.