Rapidly growing proliferative pulmonary chondroma: A case report

Abstract

Introduction: Pulmonary chondroma, a component of Carney's triad, is commonly unilateral and multiple, and progresses slowly. Herein, we report a case of a chondrogenic tumour that grew and proliferated during follow-up.

Presentation of case: A female patient in her 20s presenting with a cough was found to have a 1.4-cm nodule in the left lung on computed tomography (CT). After 18 months' follow-up, CT revealed that the original nodule had increased to 2.2 cm, and a new 1.3-cm nodule had appeared. She was then referred to our hospital and underwent a robot-assisted lower lobectomy of the left lung. The tumour was diagnosed as a chondrogenic tumour. She had no problems after the surgery or during follow-up; other signs of the Carney's triad were ruled out. Twenty-six months postoperatively, there was no evidence of recurrence.

Discussion: One report suggests that the growth of pulmonary chondroma is slow, but the present case showed an increase in both the size and number of tumours within 2 years without any symptoms. The chondroma did not recur after the surgery, though her pulmonary tumours had grown and proliferated rapidly. Furthermore, it has been reported that an average of 8.4 years is needed for another sign of Carney's triad to appear; therefore, careful follow-up should be continued.

Conclusion: This report suggests that pulmonary chondroma can grow and proliferate rapidly and asymptomatically, and can be controlled by complete resection.

Keywords: Carney's triad; Case report; Lobectomy; Pulmonary chondroma.

Fig. 1.

Computed tomography (CT) at initial presentation. a) CT shows a 1.4-cm nodule in the lower lobe of the left lung (black arrow). b) Positron emission tomography (PET) shows very little accumulation (white arrow).

Fig. 2.

a) A chest radiograph showing the nodule noted on CT. The black arrow indicates the tumour. b) Chest radiograph of the nodule after 18 months of follow-up. The white arrow indicates the tumour.

Fig. 3.

First CT after being referred to our hospital. The black arrows indicate that the original nodule had increased to 2.2 cm, and a new 1.3 cm nodule had appeared. The primary nodule had a chondrocyte component (white arrow), but the new daughter nodule did not (white triangle).

Fig. 4.

a) Gross findings. Two white, smooth-surfaced nodules were observed (white and black arrows). b) Microscopic findings (hematoxylin and eosin staining). Bone and fatty tissue (white arrow) surrounded by a cartilage matrix (black arrow) were observed and a diagnosis of pulmonary chondroma was made.