Conversion to thoracotomy during VATS segmentectomy for treatment of symptomatic endobronchial hamartoma
| Autor: | Albina Palma, Dino Casazza, Dario Amore, Carlo Curcio, Davide Di Natale, Pasquale Imitazione, Roberto Scaramuzzi, Antonio Molino |
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| Rok vydání: | 2018 |
| Předmět: |
Bronchus
medicine.medical_specialty Surgical team business.industry medicine.medical_treatment respiratory system 030204 cardiovascular system & hematology medicine.disease respiratory tract diseases 03 medical and health sciences Pneumonectomy 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Endobronchial Hamartoma Segmental Bronchus Medicine Hamartoma Surgery Endobronchial Lesion Radiology Thoracotomy business |
| Zdroj: | International Journal of Surgery Case Reports. 51:272-274 |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2018.09.006 |
| Popis: | Introduction Most hamartomas are located peripherally in the lung parenchyma and are rarely identified as an endobronchial lesion. Clinically patients with an endobronchial hamartoma are often symptomatic and may present with various symptoms including: fever, wheezing, hemoptysis and obstructive pneumonia. Case presentation A 68-year-old man presented with complaints of fever and cough for 1 month. Chest X-ray revealed a right infrahilar density, which on chest CT was found to be a lesion obstructing the superior segmental bronchus of the right lower lobe and extending outside of the bronchus. A round rubbery mass obstructing the same segmental bronchus was noticed during bronchoscopy and endoscopic biopsy yielded a pathological diagnosis of hamartoma. Discussion Bronchoscopy is most helpful in diagnosis and management of endobronchial hamartomas but if the lung distal to the obstruction is irreversibly damaged or imaging studies suggest that tumor extends outside of the bronchus, pulmonary segmentectomy, lobar resection or even pneumonectomy may be indicated. Conclusion When a benign tumor of the lung, as endobronchial hamartoma, is located in a segmental bronchus and presents extrabronchial spread, we recommend to perform a parenchymal-sparing surgical resection. In this case surgical team, however, should keep in mind, due to difficult individual dissection of the segmental bronchovascular elements, the possibility of conversion from VATS (video-assisted thoracic surgery) to open thoracotomy. |
| Databáze: | OpenAIRE |
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