Author(s)
Kastley Marvin1, Ronak Rahmanian2,3, Matthew Brigger2,3
Affiliation(s)
1 Naval Medical Center San Diego, 2 Rady Children's Hospital San Diego, 3 University Of California San Diego
Abstract:
Lobular capillary hemangioma (LCH), or pyogenic granuloma, is a relatively common lesion found on the skin or mucous membranes. Many of these are found on the gingiva, oral cavity mucosa, or nasal mucosa. LCH is a rare entity in the lower upper airway, including the larynx and trachea. There have been reports of supraglottic LCH in pediatric patients, however none involving the trachea in the pediatric population. We present the case of a 14-year-old otherwise healthy male who presented with a two day history of acute onset significant hemoptysis. The flexible laryngoscopy examination was unremarkable with the exception of blood tinged mucous present below the level of the vocal cords. CT angio was initially reviewed as normal. Flexible bronchoscopy identified a pedunculated vascular mass arising from the anterior mid tracheal wall. On further review of CT scan, this lesion was localized with no evidence of any major communicating vessels. Therefore the lesion was successfully excised on rigid bronchoscopy using cup forceps and CO2 laser. Pathologic review of the mass was consistent with a lobular capillary hemangioma. This is the first report of a tracheal LCH in a pediatric patient. In pediatric patients, the most frequent causes of hemoptysis include infectious (including tuberculosis), trauma (including foreign body aspiration and iatrogenic causes), tumors and vascular malformations. Although rare, LCH should be considered as a possible benign cause of hemoptysis.