Solitary hamartoma of the lung: is thoracotomy still mandatory?

Solitary pulmonary hamartomas are the most common benign tumors of the lung, and have to be distinguished from primary or secondary malignant pulmonary lesions. The data of 20 patients operated for a solitary hamartoma of the lung are presented with special attention to the diagnostic methods which can contribute to the diagnosis. To avoid a surgical procedure, CT-densitometry and fine-needle aspiration biopsy have become of major interest for the diagnosis of hamartoma. Using in succession chest X-rays, CT-densitometry and fine-needle aspiration biopsy, a conservative approach can be advised in specific cases. However, exploratory thoracotomy is mandatory when a patient presents with a solitary pulmonary lesion of more than 2.5 cm or when the lesion shows a tendency to grow.