Resection of Giant Endobronchial Hamartoma by Electrocautery and Cryotherapy Via Flexible Bronchoscopy

Endobronchial hamartoma is a rare tumor which is 3-10% of all hamartomas. We presented a case of endobronchial hamartoma that was resected and ablated with electrocautery and cryotherapy by fiberoptic bronchoscopy. A 71-year-old male, presented with progressive dyspnea on exertion, chest pain and hemoptysis. Chest computed tomography (CT) scan of the patient revealed a mass lesion mostly obliterating tracheal lumen and left main bronchus. An initial bronchoscopy showed a large polypoid lesion within the left mainstem bronchus. Polypoid lesion protrudes to the right with respiration. Interventional bronchoscopy with snare probe of the electrocautery resected the polyp in 4 pieces followed by cryotherapy of the base. Pathology of the resected lesion diagnosed as bronchial hamartoma with fibrovascular component. Control bronchoscopy applied 10 days later revealed patency of all airways. The majority of hamartomas is parenchymal and is often located in the periphery of the lung, unlike our patient who had a more central lesion. Where a firm diagnosis is made preoperatively, surgical removal may not be necessary unless symptoms are present, or tumor expansion is noted. Our case demonstrates resection of an endobronchial hamartoma by snare probe of the electrocautery and with cryotherapy. Electrocautery and cryotherapy may present an alternative therapy for resection of selected benign endobronchial benign tumors.