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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

Photograph of histopathological specimen showing multiple dilated vascular spaces containing a few red blood cells (A, H&E stain, ×200; B, H&E stain, ×400).
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Figure 3: Photograph of histopathological specimen showing multiple dilated vascular spaces containing a few red blood cells (A, H&E stain, ×200; B, H&E stain, ×400).

Mentions: The patient was admitted and treated with intravenous tranexamic acid. Subsequently, no further hemoptysis was found until 1-week postbronchoscopy. Chest CT scans with contrast enhancement showed a focal enhancement <5 mm in the midline of the anterior tracheal wall (Figure 2A, arrow). The polypoid lesion was diagnosed as a presumptive tracheal hemangioma. We referred the patient to a tertiary referral hospital for therapeutic bronchoscopic laser ablation. The hospital staff recommended a wait-and-see policy; however, 3 days later he was admitted to our hospital for recurrent episodes of massive hemoptysis. During the follow-up bronchoscopy, approximately 500 mL of blood was suctioned from the tracheal polypoid lesion (Figure 1B). A consult was arranged with the otorhinolaryngology department. The patient underwent an emergency operation for the tracheal lesion, under general anesthesia on the 10th day of hospitalization. A 4-mm-sized, hemorrhagic and polypoid lesion was found about 5 mm below the glottis. The lesion was removed by CO2 laser (2 watt, super-pulse, continuous mode) under rigid laryngoscopy. After removal, bleeding from tracheal mucosa was controlled by coagulation with a suction Bovie. The patient had no further episodes of hemoptysis during the 12 months postoperative follow-up period. Histopathology showed several dilated spaces generally with degenerated lining cells; the dilated spaces lined by flattened cells focally, contained few red blood cells (Figure 3). A diagnosis of tracheal cavernous hemangioma was made. One-week follow-up flexible bronchoscopy showed healing and scarring of the lesion with no evidence of bleeding (Figure 1C). The tracheal nodular lesion had disappeared in the 6-month follow-up chest CT scans (Figure 2B).


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)

Photograph of histopathological specimen showing multiple dilated vascular spaces containing a few red blood cells (A, H&E stain, ×200; B, H&E stain, ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Photograph of histopathological specimen showing multiple dilated vascular spaces containing a few red blood cells (A, H&E stain, ×200; B, H&E stain, ×400).
Mentions: The patient was admitted and treated with intravenous tranexamic acid. Subsequently, no further hemoptysis was found until 1-week postbronchoscopy. Chest CT scans with contrast enhancement showed a focal enhancement <5 mm in the midline of the anterior tracheal wall (Figure 2A, arrow). The polypoid lesion was diagnosed as a presumptive tracheal hemangioma. We referred the patient to a tertiary referral hospital for therapeutic bronchoscopic laser ablation. The hospital staff recommended a wait-and-see policy; however, 3 days later he was admitted to our hospital for recurrent episodes of massive hemoptysis. During the follow-up bronchoscopy, approximately 500 mL of blood was suctioned from the tracheal polypoid lesion (Figure 1B). A consult was arranged with the otorhinolaryngology department. The patient underwent an emergency operation for the tracheal lesion, under general anesthesia on the 10th day of hospitalization. A 4-mm-sized, hemorrhagic and polypoid lesion was found about 5 mm below the glottis. The lesion was removed by CO2 laser (2 watt, super-pulse, continuous mode) under rigid laryngoscopy. After removal, bleeding from tracheal mucosa was controlled by coagulation with a suction Bovie. The patient had no further episodes of hemoptysis during the 12 months postoperative follow-up period. Histopathology showed several dilated spaces generally with degenerated lining cells; the dilated spaces lined by flattened cells focally, contained few red blood cells (Figure 3). A diagnosis of tracheal cavernous hemangioma was made. One-week follow-up flexible bronchoscopy showed healing and scarring of the lesion with no evidence of bleeding (Figure 1C). The tracheal nodular lesion had disappeared in the 6-month follow-up chest CT scans (Figure 2B).

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