Endobronchial hamartomas as a rare cause of chronic cough

Abstract

Hamartochondromas are rare benign lung tumors arising from the mesenchymal cells. The endobronchial location is not common (1.4 %).The symptoms are not specific and misleading mimicking a wide spectrum of diseases (Asthma, COPD, Bronchitis …) resulting in a diagnosis delay. We presented here a case of a 64-year patient who had complained of a persistent non-resolving chronic cough despite symptomatic treatments. The diagnosis of an endobronchial hamartoma was made via a repeat bronchial biopsy. The flexible endoscopy showed a white smooth polypoid mass occluding the lumen of the left laterobasal bronchus. A routine surveillance was initially considered. After a 12-year regular follow-up, he was admitted in our department of Pneumology for a recurrent pneumonia. The chest CT scan showed an endobronchial mass occluding the left laterobasal bronchus associated with an obstructive pneumonia. So, he underwent surgery. This benign neoplasia was totally removed by a segmentectomy. The post-operative macroscopic examination revealed a white, small, smooth, endobronchial mass with lobulated margins. The definitive histological exam showed a mixture of mature cartilage islands, mesenchymal tissue and fat. Therefore, the diagnosis of an endobronchial hamartoma was assessed. He was doing well one week after his hospital discharge. We also highlighted this benign lung tumor main clinical presentations, radiological findings as well as the therapeutic strategies and the outcomes.