Dumbbell Shaped Exophytic and Endobronchial Lipomatous Hamartoma

Department of Pathology, Hanyang University Hospital, Seoul, Republic of Korea.
The Thoracic and Cardiovascular Surgeon (Impact Factor: 0.98). 04/2009; 57(2):122-4. DOI: 10.1055/s-2007-989350
Source: PubMed


A 63-year-old man presented with a dumbbell-shaped mass obstructing his left upper lobe. He underwent a left upper lobectomy for suspected malignancy. An unexpected pathological diagnosis of endobronchial lipomatous hamartoma was made. Only 6 other cases have been reported in the English literature and only two cases were both endobronchial and exophytic.

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    • "The traditional surgical treatment (thoracotomy and bronchotomy) is currently indicated only in cases where the EH cannot be approached through endoscopy, or when lung resection is indicated due to irreversible parenchymal damage from longstanding airway obstruction [9,20]. "
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    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.
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