Severe Central Airway Obstruction Secondary to a Giant Endobronchial Hamartoma: A Case Report

Abstract

Central airway obstruction refers to the occlusion of more than 50% of the trachea, main stem bronchi, or lobar bronchus. It can potentially become a life-threatening condition. Pulmonary hamartomas (PH) are rare tumors with an incidence of 0.25%, constituting about 8% of all benign lung neoplasms. Only 10% of PH occur endobronchially, while the remaining appear peripherally. We present the case of a women with an endobronchial hamartoma that required emergent resection by bronchoscopy. This is 44-year-old woman, with a history of an endobronchial mass on the right main stem bronchus (RMSB) without histopathological diagnosis or surgical management. She presented with a history of chronic cough and expectoration. Upon admission, a chest X-ray was performed, showing opacities of the right lung and amputations of the RMSB. Bronchoscopy was performed and a tumor-like mass that occludes the RMSB was found, with valve effect causing intermittent occlusion. In anesthetic induction, she presents severe airway obstruction and cardiorespiratory arrest. During resuscitation maneuvers, the lesion that was obstructing the light is seen and resection was performed with electrocautery and cryotherapy probes. Histopathological report described an endobronchial chondromesenchymal hamartoma, with no signs of malignancy. The control X-ray showed adequate re-expansion of the right lung. In conclusion, although endobronchial hamartoma has a low incidence and has a slow growth rate, it can manifest as severe airway obstruction. To achieve a complete resection of an endobronchial lesion, both rigid and/or flexible bronchoscopy plus multimodal interventions are recommended.

Chronic pulmonary Aspergillosis in a patient with poorly controlled diabetes: A case report and literatures review

“…Immunocompromised conditions, such as poorly controlled diabetes mellitus, are known to be associated with CPA 18 . Poorly controlled blood glucose levels can result in dysfunction of T cells, neutrophils, and humoral immunity, prompting susceptibility to various opportunistic infections 9 . Previous studies demonstrated that diabetes is a significant risk factor for both IPA and CPA 8 .…”

“…Despite these findings, no case reports have specifically addressed this correlation to date. Moreover, while diabetes is recognized as a risk factor for both CPA and invasive pulmonary aspergillosis (IPA), 9,10 the impact of strict blood sugar control on reducing CPA activity and preventing hemoptysis recurrence remains unclear.…”