Management of endobronchial hamartoma

Pulmonary hamartomas are uncommon benign tumors with a population incidence of 0.25%. They occur in parenchymal and endobronchial locations, the latter representing 10 to 20% of the total number of pulmonary hamartomas. Parenchymal tumors are generally small (<4 cm) and well-circumscribed and present asymptomatically as an incidental radiographic finding. Endobronchial tumors are generally broad-based lobulated nodules, which grow slowly, resulting in symptoms of airway obstruction including cough, hemoptysis, dyspnea, or obstructive pneumonia. Histologically the tumors consist of varying combinations of benign elements including cartilage, connective tissue, fat, and smooth muscle. We present a 67-year-old man who presented with persistent right lower lobe pneumonia and was found to have a right mainstem endobronchial hamartoma which was resected endoscopically by laser mechanical debridement. A review of the pathobiology of endobronchial hamartoma is presented.