Bronchial pleomorphic adenoma successfully diagnosed and resected with left lower sleeve lobectomy; a case report and literature review

Abstract

Tracheobronchial tumor is a relatively uncommon type of respiratory tumor. Seromucous gland tumors, such as adenoid cystic carcinoma, mucoepidermoid carcinoma, and pleomorphic adenoma, are a part of this category. Among them, pleomorphic adenoma is especially rare. This report describes a case of bronchial pleomorphic adenoma successfully diagnosed and removed with surgery. A 70-year-old Japanese man presented with abnormal chest shadow and intermittent fever. A subsequently conducted chest computed tomography revealed a 40mm-sized mass in the left lower bronchus and distal obstructive pneumonia. Because a transbronchial biopsy was not diagnostic, a left lower sleeve lobectomy was performed. As a result, the mass was completely resected and a diagnosis of pleomorphic adenoma was made. Treatment options for pleomorphic adenoma include surgery and endoscopic resection, because observation is sometimes inadvisable due to the risk of metastasis or malignant transformation. Furthermore, complete resection is diagnostically appropriate because pleomorphic adenoma is sometimes undiagnosed or misdiagnosed with partially resected or biopsied specimen, due to the heterogeneity in pathology. This case underscores the challenges in diagnosing pleomorphic adenoma and highlights the importance of complete surgical resection for definitive diagnosis and treatment.