Archivos de Bronconeumología (English Edition) Archivos de Bronconeumología (English Edition)
Arch Bronconeumol 2017;53:518 - Vol. 53 Num.9 DOI: 10.1016/j.arbr.2017.07.009
Clinical Image
Endobronquial Leiomyoma: Outcome of Conservative Management
Resultados del manejo conservador de un leiomioma endobronquial
Francisco García Gómeza, Ana Triviñoa,, , Karla Tello Collantesb
a Servicio de Cirugía Torácica, Hospital Universitario Puerta del Mar, Cádiz, Spain
b Servicio de Anatomía Patológica, Hospital Universitario Puerta del Mar, Cádiz, Spain

We report the case of a 46-year-old woman who attended the respiratory medicine clinic due to dyspnea, MRC grade I–II. Radiological study and fiberoptic bronchoscopy revealed a rounded, hypervasculated, pedunculated mass, located 2cm from the main carina, with an implantation base of less than 1cm in the left main bronchus.

Given the characteristics of the mass and the risk of hemorrhage, we decided to perform resection under rigid fiberoptic bronchoscopy-guidance, to obtain a biopsy and resolution of the occlusion.

The patient was discharged 24h after the procedure without any incidents. A diagnosis of endobronchial leiomyoma was confirmed (Fig. 1), and the patient was followed up with flexible fiberoptic bronchoscopy and imaging tests. Nine months after treatment, she remains asymptomatic and free of disease.

Fig. 1.
(0.26MB).

Image showing a fasciculated subepithelial fusocellular tumor with no necrosis or mitotic activity (H&E ×4), with positive immunostaining for smooth muscle actin (lower image, SMA ×10).

Pulmonary leiomyoma is a rare tumor of mesodermal origin.1,2 Treatment of choice is resection using the most conservative technique possible. For endoluminal tumors, White et al.1 and Tan et al.2 defend the treatment of endobronchial leiomyoma using an endoscopic resection technique with endoforceps, electrocautery or laser, since no reports of relapse or distant seeding have been described after limited resection.

References
1
S.H. White,N.B.N. Ibrahim,C.P. Forrester-Wood,K. Jeyasingham
Leiomyomas of the lower respiratory tract
Thorax, 40 (1985), pp. 306-311
2
J.H. Tan,A.M. Takano,A.A. Hsu
Resection with preserved histologic morphology of a rare tumour via bronchoscopic cryosurgery
J Thorac Dis, 8 (2016), pp. 2964-2967 http://dx.doi.org/10.21037/jtd.2016.10.08

Please cite this article as: García Gómez F, Triviño A, Tello Collantes K. Resultados del manejo conservador de un leiomioma endobronquial. Arch Bronconeumol. 2017;53:518.

Corresponding author. (Ana Triviño atrivi_17@hotmail.com)
Copyright © 2017. SEPAR
Arch Bronconeumol 2017;53:518 - Vol. 53 Num.9 DOI: 10.1016/j.arbr.2017.07.009