A case of endobronchial leiomyoma and carcinoma in situ treated with electrocautery using flexible bronchoscopy.

An 82-year-old woman presented with dyspnea, fever, cough, and an endobronchial mass in the right main stem bronchus. Initial bronchoscopy revealed 80% obstruction of the distal right main bronchus by an exophytic tumor mass. Endobronchial biopsy of the mass revealed squamous cell carcinoma in situ. A repeat flexible bronchoscopy was performed to obtain a deeper biopsy for definitive diagnosis and to relieve the obstruction. A hot forceps biopsy using electrocautery (20 W) was performed; no significant bleeding was encountered. A less vascular tumor was suspected because of the minimal bleeding, which led to the decision to ablate and excise the entire mass using electrocautery. The hot forceps biopsy of the endobronchial lesion revealed leiomyoma and no further evidence of carcinoma in situ. Follow-up bronchoscopy at 3 and 6 months showed no recurrence. Flexible bronchoscopy with electrocautery spared an elderly patient from a higher risk procedure and general anesthesia. This approach may be considered as an option for high-risk patients with vascular lesions.