All issues > Volume 43(7); 2000

Case Report

J Korean Pediatr Soc. 2000;43(7):1000-1005. Published online July 15, 2000.

Hemangioendothelioma Leading to Obstruction of the Left Main Bronchus in Infant

Bong Seong BS Kim¹, Jung Yeon JY Shim², Seung Il SI Park³, Sung Hye SH Park⁴, Soo-Jong SJ Hong¹

¹Departments of Pediatrics, Asan Medical Center, College of M edicine, Ulsan University, Seoul, Korea
²Department of Pediatrics, Kangbuk Samsung, H ospital, Sungkunkwan University School of M edicine, Seoul, Korea
³Departments of Chest Surgery, Asan M edical Center, College of M edicine, Ulsan University, Seoul, Korea
⁴Departments of Diagnostic Pathology, Asan Medical, College of Medicine, Ulsan University, Seoul, Korea

Correspondence Soo-Jong SJ Hong ,Email: sjhong@www.amc.seoul.kr

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 of 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, hypervascular protruding mass. Lung scans showed markedly decreased perfusion in the left lung. At the age of 4 months, a sleeve of the left main bronchus was resected and end-to-end anastomosis performed. The excised specimen contained a hemangioendothelioma measuring 1.5¡¿1.5cm. Anastomotic site narrowing was observed on postoperative bronchoscopy, but ventilation of the left 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 the causes of bronchial obstruction during infancy.

Keywords :Hemangioendothelioma, Bronchial obstruction, Infant