Endobronchial Lipoma: A Hidden Obstruction Behind Chronic Cough

Endobronchial lipomas are rare, benign tumours that arise from the submucosal fat of the bronchial wall and account for less than 0.5% of all lung tumours. These tumours can present with non-specific respiratory symptoms, often mimicking common pulmonary conditions such as asthma, COPD, or infections, making diagnosis challenging. We present the case of a 54-year-old female smoker who experienced a three-month history of chronic productive cough, dyspnea and recurrent respiratory infections. During this period, she was evaluated by three healthcare providers, each of whom prescribed multiple courses of antibiotics and inhaled bronchodilators based on presumed diagnoses of bronchitis or COPD exacerbation. Notably, no chest imaging was performed at the initial stages. Chest imaging revealed left lung collapse, and bronchoscopy revealed a polypoidal mass obstructing the left main bronchus. Histopathological analysis confirmed the diagnosis of an endobronchial lipoma. This case highlights the importance of considering benign bronchial tumours in the differential diagnosis of chronic respiratory complaints, especially in patients with a smoking history. Complete excision, either bronchoscopic or surgical, is the treatment of choice, resulting in excellent prognosis and symptom resolution.