Bronchoscopic management of endobronchial hamartomas using “hot and cold” therapies – Initial experience in two patients

Pulmonary hamartomas are the most common benign tumours of the lung and are often detected incidentally. Endobronchial hamartomas, though rare, can cause significant symptoms such as dyspnoea, haemoptysis, and recurrent respiratory infections due to bronchial obstruction. This report describes the successful bronchoscopic management of symptomatic endobronchial hamartomas in two young Indian males aged 29 and 34 years. Both cases were diagnosed based on radiological and histopathological findings. The first patient underwent eight sessions of electrocautery fulguration using a flexible bronchoscope, while the second was treated with six sessions of cryotherapy delivered through a flexible bronchoscope guided cryoprobe. All procedures were carried out under conscious sedation via nasal insertion of the flexible bronchoscope, with no requirement for rigid bronchoscopy or general anaesthesia. Both patients showed marked symptomatic improvement and near-complete resolution of endobronchial lesions. Follow-up bronchoscopies at 18 and 12 months, respectively, revealed no recurrence, and no procedure-related complications were observed. These cases highlight the safety, efficacy, and minimally invasive nature of flexible bronchoscopic techniques such as electrocautery and cryoablation in managing endobronchial hamartomas, particularly in settings where surgical options may be limited.