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Massive Hemoptysis due to Endotracheal Hemangioma: A Case Report and Literature Review.

Yu Y, Lee S, An J, Lee J, Kim J, Lee Y, Jung E, Song S, Kim H, Kim S - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: Tracheal hemangioma is a rare benign vascular tumor in adults.We reported a case of massive hemoptysis caused by a cavernous hemangioma in a 75-year-old man.Endovascular tumors, such as tracheobronchial hemangiomas, should be considered a diagnostic option in cases of massive hemoptysis without a significant underlying lung lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.

ABSTRACT
Tracheal hemangioma is a rare benign vascular tumor in adults. We reported a case of massive hemoptysis caused by a cavernous hemangioma in a 75-year-old man. This is the first report, to our knowledge, of a tracheal cavernous hemangioma that presented with massive hemoptysis. The lesion was removed with a CO2 laser under rigid laryngoscopy. Endovascular tumors, such as tracheobronchial hemangiomas, should be considered a diagnostic option in cases of massive hemoptysis without a significant underlying lung lesion.

No MeSH data available.


Related in: MedlinePlus

Bronchoscopic findings. (A) Initial bronchoscopy showed a polypoid lesion on the ventral wall of the trachea, 5 mm below the vocal cord. (B) Follow-up bronchoscopy showed massive bleeding on the polypoid lesion. (C) Postoperative bronchoscopy showed healing and scarring of the lesion with no evidence of bleeding.
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Figure 1: Bronchoscopic findings. (A) Initial bronchoscopy showed a polypoid lesion on the ventral wall of the trachea, 5 mm below the vocal cord. (B) Follow-up bronchoscopy showed massive bleeding on the polypoid lesion. (C) Postoperative bronchoscopy showed healing and scarring of the lesion with no evidence of bleeding.

Mentions: A 75-year-old man presented with hemoptysis in our outpatient clinic. He had recurrent episodes of blood tinged sputum and minor hemoptysis during the past year. He had a history of smoking an average of 55 pack-year of cigarettes and had bronchial asthma. Recently, he had also been diagnosed with smear-negative pulmonary tuberculosis (TB) in the public health center and was treated with anti-TB drugs. The results of hematologic and chemical laboratory tests were unremarkable. Chest radiography showed small nodules with linear opacities in the left upper lung zones. Low dose chest computed tomography (CT) scans without contrast enhancement showed small calcified nodules with linear opacities in the left upper lobe. The opacities in the left upper lobe were unchanged in comparison with low dose chest CT scans examined 10 months ago. Occasional hemoptysis persisted despite the ongoing anti-TB therapy and oral tranexamic acid administered for about a month. Flexible bronchoscopy performed under local anesthesia, revealed an approximately 6 mm-sized, well-circumscribed, reddish hypervascular, multiloculated, polypoid lesion found on the ventral wall of the tracheal midline, 5 mm below the vocal cords (Figure 1A). The other parts of the trachea and bronchi were unremarkable. Bleeding from the polypoid lesion occurred on intra-procedural coughing. The bleeding stopped after endobronchial instillation of 1:10,000 diluted epinephrine. However, forcep biopsy without laser coagulation equipment was not attempted due to the possibility of profuse intra-procedural bleeding.


Massive Hemoptysis due to Endotracheal Hemangioma: A Case Report and Literature Review.

Yu Y, Lee S, An J, Lee J, Kim J, Lee Y, Jung E, Song S, Kim H, Kim S - Tuberc Respir Dis (Seoul) (2015)

Bronchoscopic findings. (A) Initial bronchoscopy showed a polypoid lesion on the ventral wall of the trachea, 5 mm below the vocal cord. (B) Follow-up bronchoscopy showed massive bleeding on the polypoid lesion. (C) Postoperative bronchoscopy showed healing and scarring of the lesion with no evidence of bleeding.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388893&req=5

Figure 1: Bronchoscopic findings. (A) Initial bronchoscopy showed a polypoid lesion on the ventral wall of the trachea, 5 mm below the vocal cord. (B) Follow-up bronchoscopy showed massive bleeding on the polypoid lesion. (C) Postoperative bronchoscopy showed healing and scarring of the lesion with no evidence of bleeding.
Mentions: A 75-year-old man presented with hemoptysis in our outpatient clinic. He had recurrent episodes of blood tinged sputum and minor hemoptysis during the past year. He had a history of smoking an average of 55 pack-year of cigarettes and had bronchial asthma. Recently, he had also been diagnosed with smear-negative pulmonary tuberculosis (TB) in the public health center and was treated with anti-TB drugs. The results of hematologic and chemical laboratory tests were unremarkable. Chest radiography showed small nodules with linear opacities in the left upper lung zones. Low dose chest computed tomography (CT) scans without contrast enhancement showed small calcified nodules with linear opacities in the left upper lobe. The opacities in the left upper lobe were unchanged in comparison with low dose chest CT scans examined 10 months ago. Occasional hemoptysis persisted despite the ongoing anti-TB therapy and oral tranexamic acid administered for about a month. Flexible bronchoscopy performed under local anesthesia, revealed an approximately 6 mm-sized, well-circumscribed, reddish hypervascular, multiloculated, polypoid lesion found on the ventral wall of the tracheal midline, 5 mm below the vocal cords (Figure 1A). The other parts of the trachea and bronchi were unremarkable. Bleeding from the polypoid lesion occurred on intra-procedural coughing. The bleeding stopped after endobronchial instillation of 1:10,000 diluted epinephrine. However, forcep biopsy without laser coagulation equipment was not attempted due to the possibility of profuse intra-procedural bleeding.

Bottom Line: Tracheal hemangioma is a rare benign vascular tumor in adults.We reported a case of massive hemoptysis caused by a cavernous hemangioma in a 75-year-old man.Endovascular tumors, such as tracheobronchial hemangiomas, should be considered a diagnostic option in cases of massive hemoptysis without a significant underlying lung lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.

ABSTRACT
Tracheal hemangioma is a rare benign vascular tumor in adults. We reported a case of massive hemoptysis caused by a cavernous hemangioma in a 75-year-old man. This is the first report, to our knowledge, of a tracheal cavernous hemangioma that presented with massive hemoptysis. The lesion was removed with a CO2 laser under rigid laryngoscopy. Endovascular tumors, such as tracheobronchial hemangiomas, should be considered a diagnostic option in cases of massive hemoptysis without a significant underlying lung lesion.

No MeSH data available.


Related in: MedlinePlus