Giant endobronchial hamartoma resected by fiberoptic bronchoscopy electrosurgical snaring

Abstract

Less than 1% of lung neoplasms are represented by benign tumors. Among these, hamartomas are the most common with an incidence between 0.025% and 0.32%. In relation to the localization, hamartomas are divided into intraparenchymal and endobronchial.Clinical manifestation of an endobronchial hamartoma (EH) results from tracheobronchial obstruction or bleeding. Usually, EH localizes in large diameter bronchus. Endoscopic removal is usually recommended. Bronchotomy or parenchimal resection through thoracotomy should be reserved only for cases where the hamatoma cannot be approached through endoscopy, or when irreversible lung functional impairment occurred after prolonged airflow obstruction. Generally, when endoscopic approach is used, this is through rigid bronchoscopy, laser photocoagulation or mechanical resection. Here we present a giant EH occasionally diagnosed and treated by fiberoptic bronchoscopy electrosurgical snaring.

Pulmonary Hamartomas: A Report of 13 Parenchymal and Endobronchial Cases

“…Only the tumors located deeply in the parenchyma or endobronchial lesions necessitate more extensive procedures such as lobectomy or pneumonectomy (3,5). Bronchoscopic procedures such as rigid forceps, laser resection, cryotherapy, and snaring are safe and effective therapeutic options for selected patients with endobronchial hamartoma (4,(13)(14)(15). In our experience, three of four endobronchal hamartomas were treated via bronchoscopic procedures.…”

“…Even with the advances in medical therapy, bronchoscopic interventions and surgical methods currently remain the most important treatment modalities in patients with pulmonary hamartoma (3,4,7,8,(13)(14)(15). However, indication and timing of surgery are still controversial.…”

Tracheobronchial mucoid pseudotumor

“…And if the lesions are too large to remove through the upper airway, photodynamic procedures such as razer therapy and endoscopic electrosurgery can be used to tear them off [16,17]. In our patient, we used biopsy forceps and removed the mucoid plug after tearing it off by the biopsy forceps under flexible bronchoscope.…”

“…Polyploidy lesion in tracheobronchus has been observed in some patients with infectious or tumorous diseases [1,2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. However, large and long mucoid plug of tracheobronchus simulating a tumor has been rarely reported [1,2].…”

Endobronchial hamartoma: a rare disease with more common presentation

“…Obstructive pulmonary symptoms have been reported 12 13. CT scans of the chest and bronchoscopy are useful diagnostic tools 2 3 7 11 16. Finally, more than one treatment modality has been described in the treatment of pulmonary hamartomas including endobronchial tumours 6 7 12 16 17.…”