0
Lung Pathology |

A Rare Case of Endobronchial Fibrous Tumor Resected Safely With Flexible Bronchoscopy and Electrocautery Snare

Virgil Secasanu, MD; Rehmat Awan, MBBS; Akrum Al-Zubaidi, DO; Steve Groshong, MD; James Ellis, MD; Ali Musani, MD
Author and Funding Information

University of Colorado, Aurora, CO


Chest. 2015;148(4_MeetingAbstracts):630A. doi:10.1378/chest.2259156
Text Size: A A A
Published online

Abstract

SESSION TITLE: Lung Pathology Student/Resident Case Report Posters

SESSION TYPE: Student/Resident Case Report Poster

PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM

INTRODUCTION: Except hamartomas and carcinoid tumors, all benign lung tumors are very rare [1]. Patients commonly present with cough, dyspnea, or hemoptysis. Surgical resection is usually the treatment of choice [2]. We report here a rare case of a patient with an endobronchial fibrous tumor that was completely resected with bronchoscopy and electrocautery snare polypectomy.

CASE PRESENTATION: A 66 year old man with no significant past medical history was referred for evaluation of dyspnea on exertion and obstructive sleep apnea. He denied chest pain, hemoptysis, fever, chills, or weight loss. There was no past history of pneumonia, lung collapse, or pleural effusion. He had a 4 pack-year smoking history. Physical examination revealed normal oxygen saturation on room air, decreased breath sounds in the left posterior fields, and no clubbing. Pulmonary function tests showed FEV1 of 58% without bronchodilator response and a normal flow volume loop. A CT chest demonstrated near complete obstruction of the Left Main Bronchus (LMB) by a 1.2cm pedunculated mass (Fig 1A). Flexible bronchoscopy was performed with rigid bronchoscopy as backup, confirming the pedunculated mass with visible vascular supply in the stalk. An electrocautery snare was passed around the stalk (Fig 1B). With simultaneous cutting and coagulation, the lesion was entirely resected without blood loss (Fig 1C). Pathologic examination of the mass demonstrated a lobulated bland fibrous tumor lined by squamous metaplasia (Fig 1D). Immuno-stains were negative for S100 and positive for bcl2 and CD34, confirming the diagnosis of a benign fibrous tumor. The patient’s dyspnea and sleep apnea instantaneously improved.

DISCUSSION: Endobronchial fibrous tumors are very rare benign lesions. Immunostaining can be positive for bcl2 and CD34. Surgical resection is usually the preferred treatment. In our patient the tumor was completely resected without complications using an electrocautery snare and flexible bronchoscopy. Electrocautery generates heat with an electric current to cut and coagulate tissue. It is a useful technique when resecting large vascular tumors [3]. Compared to other ablative tools such as laser and cryotherapy, electrocautery’s ancillary tools (such as a snare) make it especially versatile. Other benefits of electrocautery include its lower cost, ease of use, and wide availability.

CONCLUSIONS: Endobronchial benign tumors are very rare and usually require surgical resection. Here we present a case of a pedunculated endobronchial fibrous tumor safely resected with electrocautery and flexible bronchoscopy.

Reference #1: Miller DR. Benign tumors of the lung and tracheobronchial tree. Ann of Thorac Surg. 1969;8(6):542-560.

Reference #2: Li Z, et al. Surgical approaches of endobronchial neoplasms. J Thorac Dis. 2013;5(S4):S378-S382.

Reference #3: Wahidi MM, et al. The use of electrocautery as the primary ablation modality for malignant and benign airway obstruction. J Thorac Oncol. 2011;6:1516-1520.

DISCLOSURE: The following authors have nothing to disclose: Virgil Secasanu, Rehmat Awan, Akrum Al-Zubaidi, Steve Groshong, James Ellis, Ali Musani

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543