Endobronchial lipoma: a report of three cases.

Although lipomas are common benign neoplasms of soft tissue, endobronchial lipoma is rare. We have treated three patients with endobronchial lipoma over the five years. In two of them lesions were located in segmental or subsegmental bronchi and produced no symptoms. There are very few such cases reported in the English medical literature. In the first case, pneumonectomy was performed because of destruction of the lung due to recurrent pneumonia. The second case had no symptoms and the tumor was located at the bifurcation of right B4a and B4b. A right middle lobectomy was performed, because the distal end of the tumor could not be visualized by fiberoptic bronchoscopy. In the third case, which was a case of lung cancer, an endobronchial lipoma was found during fiberoptic bronchoscopy, and was completely removed endoscopically. Due to their benign nature, endobronchial lipomas should be initially treated with endoscopic surgery or endoscopic laser vaporization. Nevertheless, if the tumor is large and dumbbell-shaped on tomography or CT, endoscopic procedures are not appropriate. Furthermore, if destructive pulmonary change due to the tumor is severe, the remaining peripheral lung will not recover after endoscopic procedures, even if they are removed successfully. When the biopsy specimen is too small to allow evaluation of the whole tumor, surgical resection should also be considered for definitive diagnosis.