Hemangioendothelioma Leading to Obstruction of the Left Main Bronchus in Infant

ABSTRACT

Hemangioendothelioma is the most common vascular tumor in children, however hemangioendothelioma occurring in the bronchus is very rare. We experienced a case of hemangioendothelioma in the left main bronchus of an infant which was successfully removed by a sleeve resection. Respiratory distress developed in a 3-month-old female infant with roentgenographic finding oi' hyperinflation of the left lung. Chest CT and MRI revealed a highly vascular tumor extending from the wall of the left main bronchus leading to hyperinflation by a check-valve mechanism. Bronchoscopic finding showed left main bronchus obstruction due to a round, hypervasculm protruding mass. Lung scans showed markedly decreased perfusion in the left lung, At the age oi 4 months, a sleeve of the left main bronchus was resected and end-to-end anastomosi performed. The excised specimen contained a hemangioendothelioma measuring 1.5x1.5cm. Anastomotic site narrowing was observed on postoperative bronchoscopy, but ventilation of the lef1 lung remained relatively good. Perfusion of the left lung and respiratory distress symptom was markedly improved 2 months later. Hemangioendothelioma must be considered as one of thc causes of bronchial obstruction during infancy.