Multimodal interventional bronchoscopy for bronchial myelolipoma complicated with airway obstruction: a case report and literature review

Vollständiger Abstract

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Myelolipoma predominantly arises within the adrenal glands, while endobronchial myelolipoma is extremely rare and frequently leads to airway obstruction. We report a case of bronchial myelolipoma causing left lower lobe airway obstruction in a 62-year-old male who presented with cough and sputum. Chest computed tomography (CT) revealed a mixed-density lesion with calcification within the left lower lobe bronchial lumen, and the diagnosis was confirmed by bronchoscopic biopsy pathology. The patient underwent interventional minimally invasive interventional therapy under general anesthesia, employing flexible bronchoscopic electrosurgical snare resection combined with semiconductor laser ablation, which successfully removed the tumor and restored airway patency. We systematically reviewed the domestic and international literature and summarized all reported cases of bronchial myelolipoma (a total of 6 cases, including the present case), with a focus on the clinical decision-making basis for bronchoscopic interventional therapy versus surgical resection, and the technical considerations for selecting laser ablation over argon plasma coagulation (APC) and cryotherapy. This case demonstrates that electrosurgical snare combined with laser ablation is a safe and effective minimally invasive interventional treatment for airway obstruction caused by bronchial myelolipoma, providing a reference for the clinical diagnosis and management of this rare benign airway tumor.