The Clinical, Radiological, and Bronchoscopic Findings and Outcomes in Patients with Benign Tracheobronchial Tumors
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Purpose: We evaluated the characteristics of and treatment outcomes in patients with benign tracheobronchial tumors. Materials and Methods: We reviewed the records of patients with benign tracheobronchial tumors who underwent bronchoscopic intervention with mechanical removal and Nd: YAG laser cauterization, and evaluated the characteristics and treatment outcomes of 55 patients with hamartomas, leiomyomas, papillomas, typical carcinoids, or schwannomas seen between April 1999 and July 2012. Results: The most common tumors were hamartoma (n=24), leiomyoma (n=16), papilloma (n=7), typical carcinoid (n=5), and schwannoma (n=3). Forty-one patients (75%) had symptoms. On chest computed tomography, 35 patients (64%) had round or ovoid lesions, accompanied by atelectasis (n=26, 47%) or obstructive pneumonia (n=17, 31%). Fatty components (n=9, 16%) and calcifications (n=7, 13%) were observed only in hamartomas, leiomyomas, and typical carcinoids. At bronchoscopy, the typical findings were categorized according to tumor shape, surface, color, and visible vessels. Fifty (91%) patients underwent complete resection. Forty patients (73%) achieved successful bronchoscopic removal defined as complete resection without complications or recurrence. Recurrences occurred in four papillomas, one leiomyoma, and one typical carcinoid. The proportions of tumor types (p=0.029) differed between the successful and unsuccessful removal groups, and a pedunculated base (p<0.001) and no spontaneous bleeding (p=0.037) were more frequent in the successful removal group. Conclusion: We described clinical, radiological, and typical bronchoscopic findings in patients with benign tracheobronchial tumors; these findings might help to differentiate such tumors. Bronchoscopic intervention was a useful treatment modality, and tumor type, pedunculated base, and vascularity may influence successful tumor removal.
Abstract
Purpose: We evaluated the characteristics of and treatment outcomes in patients with benign tracheobronchial tumors. Materials and Methods: We reviewed the records of patients with benign tracheobronchial tumors who underwent bronchoscopic intervention with mechanical removal and Nd: YAG laser cauterization, and evaluated the characteristics and treatment outcomes of 55 patients with hamartomas, leiomyomas, papillomas, typical carcinoids, or schwannomas seen between April 1999 and July 2012. Results: The most common tumors were hamartoma (n=24), leiomyoma (n=16), papilloma (n=7), typical carcinoid (n=5), and schwannoma (n=3). Forty-one patients (75%) had symptoms. On chest computed tomography, 35 patients (64%) had round or ovoid lesions, accompanied by atelectasis (n=26, 47%) or obstructive pneumonia (n=17, 31%). Fatty components (n=9, 16%) and calcifications (n=7, 13%) were observed only in hamartomas, leiomyomas, and typical carcinoids. At bronchoscopy, the typical findings were categorized according to tumor shape, surface, color, and visible vessels. Fifty (91%) patients underwent complete resection. Forty patients (73%) achieved successful bronchoscopic removal defined as complete resection without complications or recurrence. Recurrences occurred in four papillomas, one leiomyoma, and one typical carcinoid. The proportions of tumor types (p=0.029) differed between the successful and unsuccessful removal groups, and a pedunculated base (p<0.001) and no spontaneous bleeding (p=0.037) were more frequent in the successful removal group. Conclusion: We described clinical, radiological, and typical bronchoscopic findings in patients with benign tracheobronchial tumors; these findings might help to differentiate such tumors. Bronchoscopic intervention was a useful treatment modality, and tumor type, pedunculated base, and vascularity may influence successful tumor removal.
참고문헌 (23)
- Arrigoni MG, "Benign tumors of the lung. A ten-year surgical experience", J Thorac Cardiovasc Surg, 60, pp.589~599 (1970)
- Thomas R, "Tracheal schwannoma as a mimic of bronchial asthma", Singapore Med J, 53, pp.e95~e96 (2012)
- Takeda S, "Management and surgical resection for tracheobronchial tumors institutional experience with 12 patients", Interact Cardiovasc Thorac Surg, 6, pp.484~489 (2007)
- Stevic R, "Clinical and radiological manifestations of primary tracheobronchial tumours: a single centre experience", Ann Acad Med Singapore, 41, pp.205~211 (2012)
- Otani Y, "Benign tumors of the lung: a 20-year surgical experience", Surg Today, 27, pp.310~312 (1997)
- Smith MA, "Prevalence of benign disease in patients undergoing resection for suspected lung cancer", Ann Thorac Surg, 81, pp.1824~1828 (2006)
- Shah H, "Benign tumors of the tracheobronchial tree. Endoscopic characteristics and role of laser resection", Chest, 107, pp.1744~1751 (1995)
- Rodrigues AJ, "Minimally invasive bronchoscopic resection of benign tumors of the bronchi", J Bras Pneumol, 37, pp.796~800 (2011)
- Sharifi N, "Endobronchial leiomyoma; report of a case successfully treated by bronchoscopic resection", J Res Med Sci, 15, pp.364~370 (2010)
- Lamprecht B, "Successful bronchoscopic cryorecanalization in a case of endobronchial lipoma", Diagn Ther Endosc, 2011, pp.845686~ (2011)
- Paganin F, "A solitary bronchial papilloma with unusual endoscopic presentation: case study and literature review", BMC Pulm Med, 9, pp.40~ (2009)
- Stouffer CW, "Endobronchial schwannoma presenting with bronchial obstruction", Interact Cardiovasc Thorac Surg, 10, pp.133~134 (2010)
- Suzuki H, "Endobronchial neurogenic tumors treated by transbronchial electrical snaring and Nd-YAG laser abrasion: report of three cases", Surg Today, 35, pp.243~246 (2005)
- Righini CA, "Primary tracheal schwannoma: one case report and a literature review", Eur Arch Otorhinolaryngol, 262, pp.157~160 (2005)
- Kim SA, "Bronchoscopic features and bronchoscopic intervention for endobronchial hamartoma", Respirology, 15, pp.150~154 (2010)
- Kwon YS, "Clinical characteristics and efficacy of bronchoscopic intervention for tracheobronchial leiomyoma", RESPIROLOGY, 13(6), pp.908~912 (2008), BLACKWELL PUBLISHING
- Park JS, "Primary leiomyoma of the trachea, bronchus, and pulmonary parenchyma--a single-institutional experience", Eur J Cardiothorac Surg, 41, pp.41~45 (2012)
- Blanco I, "Proposed terms for endobronchial lesions in patients suspected of having a bronchial neoplasm", Arch Bronconeumol, 43, pp.36~39 (2007)
- Ko JM, "Benign tumors of the tracheobronchial tree: CT-pathologic correlation", AJR Am J Roentgenol, 186, pp.1304~1313 (2006)
- Kurkcuoglu IC, "Endobronchial lipomatous hamartoma", Asian Cardiovasc Thorac Ann, 13, pp.372~373 (2005)
- Cosío BG, "Endobronchial hamartoma", Chest, 122, pp.202~205 (2002)
- Meisinger QC, "CT features of peripheral pulmonary carcinoid tumors", AJR Am J Roentgenol, 197, pp.1073~1080 (2011)
- Kasahara K, "Two cases of endobronchial neurilemmoma and review of the literature in Japan", Intern Med, 42, pp.1215~1218 (2003)