title: Endobronchial lipoma: review of 64 cases reported in Japan.
abstract: BACKGROUND
  Several recent studies discuss bronchoscopic techniques for treating endobronchial lipoma, an extremely rare benign tumor.
  
  
  OBJECTIVE
  To describe the epidemiology of endobronchial lipoma and to propose appropriate therapeutic policies for treating this tumor.
  
  
  METHODS
  We reviewed 64 cases of endobronchial lipoma: 33 cases previously reported in 30 different articles, and 31 case reports presented at thoracic meetings in Japan.
  
  
  RESULTS
  Of the 64 patients included in this study (50 male and 14 female; mean age, 60 years), 40 patients had endobronchial lipoma in the right lung and 23 patients had it in the left lung. The overwhelming majority of the tumors (n = 61) were found in the first three subdivisions of the tracheobronchial tree. Forty-eight patients (75%) were symptomatic, and their symptoms included cough, sputum, hemoptysis, elevated temperature, and dyspnea. Additionally, abnormal radiographic findings were reported for 51 patients (80%): 18 patients had atelectasis, 14 patients had infiltration or consolidation, 6 patients showed volume loss of the lung, and mass shadow was identified in 9 patients, and another abnormality including pleural effusion was found in 4 patients. Forty patients underwent surgical resection: 4 pneumonectomies, 24 lobectomies, 8 bilobectomies, and 4 resections by bronchotomy. Bronchoscopic resection was carried out in 17 cases: 7 cases by Nd-YAG laser, 5 cases by electrosurgical snaring forceps, and another 5 cases with a combined therapy using both procedures.
  
  
  CONCLUSIONS
  Bronchoscopic resection should be considered as the first choice of treatment for endobronchial lipoma; however, surgical therapy is indicated for patients who show the possibility of a complicated malignant tumor, who have destructive peripheral lung disease, who have extrabronchial growth, or who may have technical difficulties during the bronchoscopic procedure.
authors.affiliation: First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan. ceb17760@hkg.odn.ne.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Muraoka
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oka
authors.forename: Shinji
authors.initials: S
authors.lastname: Akamine
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
authors.forename: Masachika
authors.initials: M
authors.lastname: Iseki
authors.forename: Naofumi
authors.initials: N
authors.lastname: Suyama
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ayabe
mesh_terms: D001984:Bronchial Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007564:Japan; D008067:Lipoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008875:Middle Aged