Endobronchial hamartoma is a rare tumor which may present with bronchial obstruction1. We present a case of endobronchial hamartoma that was completely resected and ablated with electrocautery and argon plasma coagulation by fiberoptic bronchoscopy.
A 63 year old white male initially presented to the pulmonary clinic with progressive dyspnea on exertion and chest pain. A CT scan of the chest revealed a filling defect in the proximal left lower lobe bronchus with partial atelectasis of the posterior medial segment of the left lower lobe. An initial bronchoscopy showed a large polypoid lesion within the left mainstem bronchus arising from the origin of the left lower lobe. Biopsy specimens revealed benign polyp. Interventional bronchoscopy with loop electrocautery resected the polyp in approximately four pieces followed by argon plasma ablation of the base. Pathology of the resected lesion diagnosed bronchial hamartoma with lipomatous component. The patient’s dyspnea resolved. Repeat bronchoscopy 2 months later revealed patency of all airways with no residual tumor.DISCUSSION: Endobronchial tumors may present with obstruction of a bronchus and resultant atelectasis and/or bronchiectasis. Pulmonary hamartomas are benign, and rarely recur after complete surgical excision1. Surgical resection has been recommended for these patients, but may involve the surgical risks inherent to a thoracotomy. Nd-YAG Laser resection by flexible bronchoscopy has been attempted2. Our case demonstrates complete resection of an endobronchial hamartoma by electrocautery with argon plasma coagulation.CONCLUSIONS: Electrocautery and argon plasma coagulation may represent an alternative therapy for resection of selected benign endobronchial tumors.
J.B. Jura, None.