Giant endobronchial hamartoma resected by fiberoptic bronchoscopy electrosurgical snaring

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.Most tumors of the tracheobronchial tree are malignant [1,2]. Benign lung tumors represent less than 1%, and among these, hamartomas, with an incidence between 0.025% and 0.32%, are the most common [3]. In relation to the localization, hamartomas are divided into intraparenchymal, generally asymptomatic and with a radiological coin lesion appearance [4], and endobronchial, clinically manifesting as a result of tracheobronchial obstruction [5].From a previous paper reviewing a total of 215 cases of hamartoma reported in the literature, the endobronchial location was found in only 1.4% of cases [6]. In contrast, other studies found an incidence of endobronchial location in 10 and 20% of all pulmonary hamartomas [7,8]. The endobronchial hamartomas (EH) usually localize in large diameter bronchus [2]. Since these tumors are benign, endoscopic removal is usually recommended, reserving lung resection to cases of longstanding bronchial obstruction with infection and irreversible lung injury [9].We report the case of a giant hamartoma of the left main bronchus, diagnosed and removed by fiberoptic bronchoscopy electrosurgical snaring.An asymptomatic 65 year old man, previously treated by rectum resection for adenocarcinoma, during follow-up examination for his neoplastic disease underwent chest C