ENDOBRONCHIAL HAMARTOMA: A MISDIAGNOSIS OF COPD

TOPIC: Procedures TYPE: Medical Student/Resident Case Reports INTRODUCTION: Hamartomas are benign tumors composed of various mesenchymal cells including cartilage, connective tissue, bone and fat. Pulmonary hamartomas constitute about 8% all lung neoplasms have an incidence 0.025-0.32%. They typically occur peripherally involving the parenchyma rarely as endobronchial tumors. Here, we present a case hamartoma presenting dyspnea chronic cough. CASE PRESENTATION: A 61-year-old male non-smoker presented for 6 months productive His chest x-ray was unremarkable. function testing notable mild obstruction with forced expiratory volume in one second (FEV1) 84.9%, vital capacity (FVC) 102.1%, FEV1/FVC ratio 63.74% normal DLCO without bronchodilator response. He initially diagnosed obstructive pulmonary disease (COPD) prescribed daily steroid inhaler needed short acting bronchodilator. Despite compliance his inhalers, he continued to persistent cough referred pulmonologist. computed tomography scan showed two soft tissue lesions right bronchus intermedius nearly occluding intermedius. Diagnostic bronchoscopy lobulated, mobile mass obstructing approximately 85% lumen. Endobronchial biopsies returned fragments mature hyaline cartilage adipose bronchial epithelium compatible hamartoma. underwent rigid tumor resection laser cautery base by thoracic surgery. Pathology confirmed diagnosis After resection, had improvement DISCUSSION: account only 10% hamartomas. Most asymptomatic they involve parenchyma. most commonly post pneumonia or hemoptysis. Less frequently, non-specific symptoms such cough, wheezing, and/or can be sign lead misdiagnosis asthma COPD. CONCLUSIONS: Although common, very rare. malignant. slow growing therefore often incidentally discovered on imaging. In some cases, may poorly not visualized radiograph. Patients nonspecific who fail standard management unremarkable radiograph should prompt further detailed imaging rule out structural causes The gold symptomatic is therapy. REFERENCE #1: Cosío, Broja et al. "Endobronchial Hamartoma.” Chest. Vol. 122;1 (2002): 202-205. #2: Ahmed, Saman hamartoma; rare cause cough.” Respiratory medicine reports. 22 (2017): 224-227. #3: Stevic, Ruza, Branislava Milenkovic. "Tracheobronchial tumors.” Journal vol. 8,11 (2016): 3401-3413. DISCLOSURES: No relevant relationships Kathy Chan, source=Web Response George Moran, Sudhir Rajan, Eduardo Solbes,