An Unexpected Cause of Hemoptysis: Endobronchial Lipomatous Hamartoma

Abstract

Hamartomas are the most common benign tumors of the lung. Endobnronchial hamartomas are even rarer and infrequently causes hemoptysis. We report a case of endobronchial hamartoma that was originating from a segment bronchus and invisible in chest X-ray. A 63-year-old man was admitted to hospital with hemoptysis. A CT scan revealed endobronchial mass obstructing anterior bronchus of the right lower lob of the right lung. It wasn’t radiographically presented. Flexible bronchoscopy detected a polypoid mass (1.5x1.0 cm) that arising from the posterior wall of the anterior segment of right lower lob. Histopathologic examination revealed lipoumatous hamartoma. It was resected with an electro-surgical snare. Cryotherapy was applied to residual lesion on surface of the bronchus. The patient was successfully recovered. In conclusion, lipoumatous hamartoma may presented as rare cause of hemoptysis. Endoscopic treatment is safe and currently modality used for select cases.

Endobronchial lipoma causing progressive dyspnea

“…In contrast, endobronchial hamartomas usually appear as collections of fat alternating with foci of calcification [3].…”

Endobronchial hamartoma; a rare structural cause of chronic cough

“…Only 10% of pulmonary hamartomas occur endobronchially, while the rest are peripheral [2] . They occur more commonly in males and the peak incidence is in the six to seventh decade of life [4] , [5] . They are usually small and well demarcated.…”

“…They are usually small and well demarcated. Average size is 1.5 cm, but some can grow as big as 6 cm, causing irreversible destruction of lung tissue [4] , [5] , [6] .…”

Bronchial artery embolization for treatment of hemoptysis caused by peripheral pulmonary hamartoma

“…The endobronchial hamartoma is the uncommon cause of hemoptysis, while extrabronchial hamartoma is not the known cause of hemoptysis. [ 1 ] Only 10% of the hamartomas are endobronchial and rest are peripheral. [ 2 ] These are more common in males of sixth to seventh decade age group.…”

“…[ 2 ] These are more common in males of sixth to seventh decade age group. [ 1 ] We discuss a case of peripheral hamartoma which caused hemoptysis in a middle-aged group female. Hemoptysis was successfully treated by bronchial artery embolization (BAE).…”