Endobronchial hamartoma in a young COVID-19 symptomatic woman. Radical endoscopic treatment with a disposable bronchoscope. Case Report

Abstract

Pulmonary hamartomas represent the most frequent family of benign lung tumors that typically involve the lung parenchyma and only rarely grow as endobronchial tumors. The elective treatment of endobronchial hamartoma is the bronchoscopic resection, and in those cases in which tumor extension and localization makes it not possible, surgical treatment must be evaluated. Patients with symptomatic COVID-19, hospitalized, frequently undergo a chest CT scan and in some cases, occasional findings may emerge, requiring diagnostic investigations such as bronchoscopy and interventional pulmonology procedures. Therefore, in such a delicate pathological condition, such as COVID-19, the need to perform bronchoscopy and interventional pulmonology procedures, minimizing the risk of viral transmission and ensuring necessary assistance, represents a great challenge for pulmonologists. In this article authors describe, for the first time in literature, a rare case of endobronchial hamartoma, radically resected using a single use bronchoscope, in a young female patient hospitalized for symptomatic COVID-19.

Endobronchial hamartoma resected via bronchoscopy using high-frequency electrosurgical snare–Preoperative strategies using virtual bronchoscopy

“…Treatment options from the 1900s to 2010 included invasive surgery such as bronchotomy, segmentectomy, lobectomy, and pneumonectomy [7] . However, the treatment of endobronchial hamartoma has advanced; currently, it is less invasive with the use of bronchoscopic excision with argon plasma coagulation, electrocautery, and tumor debulking with a flexible cryoprobe ( Table 1 ) [ 5 , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ].…”

“… Author/year Age/sex Symptoms Location (bronchus) Bronchoscopy HPE Treatment Relapse Guarino et al. [8] 35/F Cough, fever, Hemoptysis, SOB, chest pain LUL Smooth, reddish, poorly vascularized surface Well-circumscribed and non-encapsulated cartilage nodules, respiratory epithelium, and fissure of fibrous tissue Fenestrated crocodile biopsy forceps No Minalyan et al. [9] 49/M Hemoptysis, SOB LUL White mass Lipomatous hamartoma Forceps debulking with cauterization.…”