The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Tracheal Leiomyoma Treated by Electrosurgical Resection Under Rigid Bronchoscopy

기관지경을 통해 전기수술적 절제술로 치료한 기관 평활근종 1예

  • Lee, Ji-Hyun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Yang, Hae-Jin (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Min-Su (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Jae-Gon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Dae-Sik (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kang, Kyung-Woo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • 이지현 (성균관대학교 의과대학 삼성창원병원 호흡기내과) ;
  • 양혜진 (성균관대학교 의과대학 삼성창원병원 호흡기내과) ;
  • 김민수 (성균관대학교 의과대학 삼성창원병원 호흡기내과) ;
  • 이재곤 (성균관대학교 의과대학 삼성창원병원 호흡기내과) ;
  • 김대식 (성균관대학교 의과대학 삼성창원병원 호흡기내과) ;
  • 강경우 (성균관대학교 의과대학 삼성창원병원 호흡기내과)
  • Published : 2012.02.01
⟨ Previous Next ⟩

Abstract

Leiomyoma of the tracheobroncheal tree is a very rare benign tumor of the lung. Airway obstructive symptoms can be similar to those of asthma; therefore, delayed or misdiagnosis is common. Although surgical resection with bronchoplastic reconstruction has long been the standard treatment, improvements in the technique have led to therapeutic bronchoscopy replacing surgery for treatment of benign tumors of the tracheobroncheal tree. We report a case of tracheal leiomyoma that was successfully resected under rigid bronchoscopy using an electrosurgical unit and bronchial snare.

천식으로 치료받고 있던 68세 여자가 1개월 전부터 지속되는 호흡곤란을 주소로 내원하였다. 훙부전산화 단층 촬영상 기관을 막고 있는 종괴가 발견되었으며 환자는 수술적 절제를 거부하였다. 이에 전신마취하에 경직성 기관경읕 삽입하여 종양근위부에 위치한 다음 전기수술장비와 연결된 bronchoscopic snare를 통해 절제하였다. 절제한 조직 검사상 기관 평활근종으로 확인 되었다. 이후 정상 폐기능으로 회복 되었으며 전이나 재발 없이 증상의 호전을 보여 현재 경과 관찰 중이다.

Keywords

References

  1. White SH, Ibrahim NB, Forrester-Wood CP, Jeyasingham K. Leiomyomas of the lower respiratory tract. Thorax 1985;40:306-311. https://doi.org/10.1136/thx.40.4.306
  2. Kwon YS, Kim H, Koh WJ, et al. Clinical characteristics and efficacy of bronchoscopic intervention for tracheobronchial leiomyoma. Respirology 2008;13:908-912. https://doi.org/10.1111/j.1440-1843.2008.01366.x
  3. Shah H, Garbe L, Nussbaum E, Dumon JF, Chiodera PL, Cavaliere S. Benign tumors of the tracheobronchial tree: endoscopic characteristics and role of laser resection. Chest 1995;107:1744-1751. https://doi.org/10.1378/chest.107.6.1744
  4. Choi JC, Yu CM, Ryu YJ, et al. The role of endoscopic surgery for completely obstructive endobronchial benign tumor. Korean J Intern Med 2006;21:15-19. https://doi.org/10.3904/kjim.2006.21.1.15
  5. Choi HS, Kim SY, Choi CW, You JH, Kang HM, Park MJ. Use of bronchoscopic electrocautery in removing an endotracheal metastasis. Lung Cancer 2007;58:286-290. https://doi.org/10.1016/j.lungcan.2007.05.002
  6. Asimakopoulos G, Beeson J, Evans J, Maiwand MO. Cryosurgery for malignant endobronchial tumors: analysis of outcome. Chest 2005;127:2007-2014. https://doi.org/10.1378/chest.127.6.2007
  7. Schumann C, Hetzel M, Babiak AJ, et al. Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis. J Thorac Cardiovasc Surg 2010;139:997-1000. https://doi.org/10.1016/j.jtcvs.2009.06.023
  8. Bolliger CT, Sutedja TG, Strausz J, Freitag L. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur Respir J 2006; 27:1258-1271. https://doi.org/10.1183/09031936.06.00013906
  9. Boxem T, Muller M, Venmans B, Postmus P, Sutedja T. Nd-YAG laser vs bronchoscopic electrocautery for palliation of symptomatic airway obstruction: a costeffectiveness study. Chest 1999;116:1108-1112. https://doi.org/10.1378/chest.116.4.1108
  10. Mayer T, Matlak ME, Dixon J, Johnson DG, McCloskey D. Experimental subglottic stenosis: histopathologic and bronchoscopic comparison of electrosurgical, cryosurgical, and laser resection. J Pediatr Surg 1980;15:944-952. https://doi.org/10.1016/S0022-3468(80)80308-3

Cited by

  1. A Rare Case of Tracheal Leiomyoma: Role of Digital Tomosynthesis in Diagnosis and Treatment vol.81, pp.1, 2012, https://doi.org/10.3348/jksr.2020.81.1.225