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Abstract: Case Reports |

Endobronchial Chondroma: A Rare Tumor Causing Complete Left Mainstem Bronchial Occlusion FREE TO VIEW

Prashant Grover, MBBS; Richard Zuwallack, MD, FCCP
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University of Connecticut, Farmington, CT


Chest


Chest. 2003;124(4_MeetingAbstracts):262S. doi:10.1378/chest.124.4_MeetingAbstracts.262S
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INTRODUCTION:  Benign tumors of the tracheobronchial tree are rare and their incidence ranges from 1-5% of all tumors.These tumors are usually peripheral and endobronchial involvement is seldom seen. We describe a case of an endobronchial chondroma which was left untreated for 4 years due to non-compliance and grew to cause complete left lung collapse.

CASE PRESENTATION:  A 54 year old male was evaluated in the pulmonary clinic for a positive tuberculin test and persistent cough. Chest radiograph showed left upper lobe collapse. This prompted a bronchoscopy which revealed a tumor at the bifurcation of the left mainstem bronchus with complete occlusion of left upper lobe orifice. Biopsy showed benign cartilaginous tissue consistent with a chondroma. The patient was lost to follow up for 4 years when he returned with increasing cough, dyspnea and fevers. Chest xray and CT showed near total collapse of left lung with post obstructive pneumonia. A bronchoscopy showed a large tumor protuding from the left mainstem bronchus with 100% occlusion of the lumen. Specimens at bronchoscopy were identical to the tissue obtained four years back. V/Q scan did not show any ventilation or perfusion of the left lung. FEV1 was 1.92L which was reduced from 2.4L at the time of the initial presentation.The patient underwent a left pneumonectomy.

DISCUSSIONS:  Chondromas are rare benign pulmonary tumors. They are almost always found in the lung parenchyma and can be seen in association with Carney’s complex(gastric stromal sarcoma, extra-adrenal paraganglioma with pulmonary chondroma). Failure to follow up on part of our patient led to more extensive surgery with greater loss of pulmonary function. He was not a candidate for laser resection of the tumor as the lung distal to the obstruction was destroyed.

CONCLUSION:  Benign endobronchial tumors although rare should be treated early aggressively with either laser resection or surgery. If left alone they have the potential to destroy an entire lung.

DISCLOSURE:  P. Grover, None.

Monday, October 27, 2003

4:15 PM - 5:45 PM

References

Benign bronchopulmonary tumors: radiologic and pathologic findings.Journal of Computer Assisted Tomography.2002;26(5):784–796
 
Benign tumors of the tracheobronchial tree: endoscopic characteristics and role of laser resection.Chest.1995;107:1744–1751. [CrossRef]
 
Discovery of the carney complex, a familial lentiginosis-multiple endocrine neoplasia syndrome: a medical odyssey.The Endocrinologist.2003;13(1):23–30
 

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References

Benign bronchopulmonary tumors: radiologic and pathologic findings.Journal of Computer Assisted Tomography.2002;26(5):784–796
 
Benign tumors of the tracheobronchial tree: endoscopic characteristics and role of laser resection.Chest.1995;107:1744–1751. [CrossRef]
 
Discovery of the carney complex, a familial lentiginosis-multiple endocrine neoplasia syndrome: a medical odyssey.The Endocrinologist.2003;13(1):23–30
 
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