Endobronchial hamartoma removed by flexible fiberoptic bronchoscopy via electrocautery.

Hamartomas are the most common benign tumors of the lung. It is most common peripherally in the parenchyma as solitary nodule or endobronchial lesion. Endobronchial form may cause obstruction of airway, atelectasis and recurrent pneumonia. Endobronchial hamartomas may be treated by surgical intervention or bronchoscopic excision (with rigid or flexible procedures). We are presenting a case of endobronchial hamartoma successfully treated with bronchoscopic electrocautery without a need for surgical removal.

Endobronchial hamartoma.

Pulmonary hamartoma is a benign lung neoplasm and it comprises 6% of solitary pulmonary nodules. Two clinical types have been defined according to its location: intraparenchymal (90%) and endobronchial (10%). We report on a case of endobronchial hamartoma resected with electrocautery by a flexible bronchoscope (FB). A 57-year-old male patient was admitted to our clinic because of worsening dyspnea. The patient had been smoking 1 pack per day for 37 years. A solid smooth lesion with calcification, located in the distal part of the left main bronchus and partially obstructing the lumen of bronchus, was detected at computerized tomography. A mass lesion that moved with coughing was observed during FB. The polypoid mass was arising from the anterior wall of the left main bronchus. Punch biopsies were taken from the polypoid lesion and a diagnosis of bronchial papilloma was made after histopathologic examination. The patient underwent endobronchial electrosurgery and the lesion was excised using FB. Pathologic evaluation revealed it to be a cartilagenous hamartoma. In conclusion, endobronchial hamartomas are benign neoplasms of the tracheobronchial tree. Endoscopic treatment with flexible bronchoscopic electrocautery is safe and less invasive in experienced hands. Therefore, it should be considered as the primary treatment approach in selected cases.