Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity

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The clinical presentation is usually very noisy. Here, we report two interesting cases. The first patient is a 58-year-old man who was wrongly treated for chronic obstructive pulmonary disease. HC was in the lower third of the trachea. The second patient is a 43-year-old man with a history of bronchiectasis and right lower lobectomy. HC was in the middle lobe bronchus. The resection via rigid bronchoscopy with diode laser was successful without any complications. Only one patient keeps a small stable tumor residue. The rigid bronchoscopy with laser-application in tracheobronchial endoluminal HC is safe and effective. Flexible bronchoscopy is important during the follow-up." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-76/v1", "name": "Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy:..." } } ] } Home Browse Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy:... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Touil A, Sarra M, Karim D et al. Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.12688/f1000research.159445.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Clinical Practice Article Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] Amany Touil https://orcid.org/0000-0003-4123-3399 1,2 , Maazaoui Sarra 1,2 , Darragi Karim 2 , [...] Chaabane Mariem 1,2 , Znegui Tasnim https://orcid.org/0000-0001-5318-5545 1,2 , Ayadi Rahma https://orcid.org/0009-0006-6138-0504 3 , Fitouhi Nizar 4 , Baccouche Ines 5 , Racil Hager 1,2 , Chaouch Nawel https://orcid.org/0000-0001-5323-3025 1,2 Amany Touil https://orcid.org/0000-0003-4123-3399 1,2 , Maazaoui Sarra 1,2 , [...] Darragi Karim 2 , Chaabane Mariem 1,2 , Znegui Tasnim https://orcid.org/0000-0001-5318-5545 1,2 , Ayadi Rahma https://orcid.org/0009-0006-6138-0504 3 , Fitouhi Nizar 4 , Baccouche Ines 5 , Racil Hager 1,2 , Chaouch Nawel https://orcid.org/0000-0001-5323-3025 1,2 PUBLISHED 14 Jan 2025 Author details Author details 1 Department of Respiratory Diseases and Interventional Endoscopy, Pavillon 2, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia 2 Faculty of Medicine of Tunis, Research Laboratory LR12SP04, Tunis El Manar University, Tunis, Tunis, Tunisia 3 Department of Pathology, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Ariana, Tunisia 4 Department of Anesthesiology and Critical Care, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Ariana, Tunisia 5 Department of Radiology, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Ariana, Tunisia Amany Touil Roles: Data Curation, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Maazaoui Sarra Roles: Data Curation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Darragi Karim Roles: Data Curation, Visualization, Writing – Original Draft Preparation Chaabane Mariem Roles: Visualization, Writing – Original Draft Preparation Znegui Tasnim Roles: Visualization, Writing – Original Draft Preparation Ayadi Rahma Roles: Data Curation, Visualization, Writing – Original Draft Preparation Fitouhi Nizar Roles: Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Baccouche Ines Roles: Data Curation, Writing – Original Draft Preparation Racil Hager Roles: Supervision, Validation Chaouch Nawel Roles: Supervision, Validation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Tracheobronchial endoluminal hamartochondroma (HC) is a rare benign tumor, most frequently diagnosed in individuals between the sixth and seventh decades of life. The clinical presentation is usually very noisy. Here, we report two interesting cases. The first patient is a 58-year-old man who was wrongly treated for chronic obstructive pulmonary disease. HC was in the lower third of the trachea. The second patient is a 43-year-old man with a history of bronchiectasis and right lower lobectomy. HC was in the middle lobe bronchus. The resection via rigid bronchoscopy with diode laser was successful without any complications. Only one patient keeps a small stable tumor residue. The rigid bronchoscopy with laser-application in tracheobronchial endoluminal HC is safe and effective. Flexible bronchoscopy is important during the follow-up. READ ALL READ LESS Keywords Benign tumor, Tracheobronchial endoluminal hamartochondroma, Chondroid hamartoma, Rigid bronchoscopy, Flexible bronchoscopy, Diode laser Corresponding Author(s) Amany Touil ( [email protected] ) Close Corresponding author: Amany Touil Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Touil A et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Touil A, Sarra M, Karim D et al. Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.12688/f1000research.159445.1 ) First published: 14 Jan 2025, 14 :76 ( https://doi.org/10.12688/f1000research.159445.1 ) Latest published: 14 Oct 2025, 14 :76 ( https://doi.org/10.12688/f1000research.159445.2 )  There is a newer version of this article available. Suppress this message for one day. 1. Introduction Pulmonary hamartochondroma (HC) is the most common benign lung tumor; however, its tracheobronchial location is very rare. Endoscopic treatment is currently recommended as the first-line treatment for benign tracheobronchial tumors with several advantages, but it must be rapid to avoid irreversible parenchymal lesions. We report two cases of HC that were successfully treated with laser-assisted rigid bronchoscopy, a safe and effective therapeutic method. 2. Case presentation 2.1 Case report 1 A 58-year-old male with a continued 70-pack-year smoking history was referred to our department for the endoscopic treatment of an endotracheal tumor. Four years previously, the patient presented with isolated shortness of breath and was treated for chronic obstructive pulmonary disease (COPD). Physical examination showed wheezes, and spirometry had met the GOLD criteria for the diagnosis of COPD with very severe airflow limitation (post-bronchodilator FEV1: 1.02 L (29%), post-bronchodilator FEV1/FVC ratio: 45%). The patient was subsequently hospitalized for bilateral hypoxemic pneumonitis and acute respiratory failure, which was treated as COPD exacerbation with a good evolution under usual treatment. On admission in our department, his clinical examination was normal, and his oxygen saturation was 97% (room air). Laboratory tests and chest radiography revealed no abnormalities ( Figure 1 ). Chest computed tomography (CT) scan showed a hypodense pedunculated budding lesion of the left anterolateral tracheal wall located just above the carina, 12 cm from the vocal cords and measuring 17 × 15 × 10 mm ( Figure 2 ). Flexible bronchoscopy confirmed an endotracheal lesion, but biopsies were non-contributory. Based on these findings, laser-assisted mechanical resection of the tumor has been validated as a feasible treatment option. Rigid bronchoscopy, performed under general anesthesia, revealed a non-vascularized pale pink tumor located at the lower third of the trachea approximately 1 cm distal to the carina, which obstructed 60% of the tracheal lumen ( Figure 3A ). Following the initial exploration, the tumor was removed at the tip of the bronchoscope following laser treatment. On the final examination, a small tumor residue was observed ( Figure 3B ). There were no complications, and the patient was rapidly discharged. The tumor measured 18 × 10 mm ( Figure 4 ). Histopathological examination of the samples stained with Hematoxylin and Eosin (H&E) showed the presence of hypertrophic seromucous gland admixed with variable amounts of fibrous adipose tissue, spindle cells, and myxoid stroma ( Figure 5 ). The diagnosis of endobronchial HC was established. The patient subsequently underwent follow-up flexible bronchoscopies, which all revealed that the tumor residue was stable and did not obstruct the tracheal lumen with a follow-up of three years ( Figure 6 ). The patient is currently asymptomatic, and his last spirometry examination revealed no abnormalities. Figure 1. Chest radiography at admission: There was no significant abnormality. Figure 2. Chest CT-scan: Hypodense pedunculated budding lesion of the left antero-lateral tracheal wall located above the carina. Figure 3. Rigid bronchoscopy findings. (A): A pale pink tumor at the lower third of the trachea. (B): A small tumor residue. Figure 4. Macroscopic aspect: a non-vascularized pale pink budding tumor. Figure 5. Histopathological examination. A: Hypertrophic seromucous gland admixed with variable amounts of fibro adipose tissue, some spindle cells and myxoid stroma. B: Fibrous adipose tissue, spindle cells, and myxoid stroma. C: Hypertrophic seromucous gland admixed with variable amounts of fibrous tissue, spindle cells and myxoid stroma. Figure 6. Flexible bronchoscopy findings: A stable tumor residue, not obstructing the tracheal lumen. 2.2 Case report 2 A 43-year-old nonsmoker man was referred to our department for respiratory preparation before surgical excision of an endobronchial HC. Past medical history included sinonasal polyposis and diffuse bronchiectasis diagnosed at the age of 12 years with a negative etiological assessment and right lower lobectomy 4 years ago. On admission, the patient had purulent sputum with no other associated symptoms, including fever, dyspnea, or hemoptysis. Chest auscultation revealed wheezing, and the patient’s oxygen saturation level was 93% (room air). The patient was treated for a bronchial superinfection. Results of microbiological investigations were negative. Flexible bronchoscopy performed after the patient improved revealed a yellowish polylobed budding formation that completely obstructed the middle lobe bronchus ( Figure 7 ). Chest CT-scan revealed an endobronchial lesion of fatty density in the middle lobe bronchus measuring 13 mm, responsible for minimal bronchiectasis of the middle lobe downstream, with almost total atelectasis of the latter, minimal bronchiectasis of the superior lingular segment, and sequelae of right lower lobectomy ( Figure 8 ). After a multidisciplinary discussion and consideration of the patient’s history, endoscopic treatment was decided. Rigid bronchoscopy revealed a smooth pale pink tumor that completely occluded the middle lobe bronchus and protruded into the bronchus intermedius ( Figure 9 ). Diode laser treatment was performed before mechanical ablation of the tumor using the tip of the bronchoscope. After removal, total recanalization of the middle lobe bronchus and its subsegments without endobronchial secretions was observed. Macroscopic examination revealed 2 fragments measuring 1.5 * 1.5 cm and 0.5 cm long axis, yellowish in color and with a smooth surface ( Figure 10 ). No complications such as bleeding, respiratory failure, or superinfection occurred. Histopathological examination of the samples stained with Hematoxylin and Eosin (H&E) showed the presence of nodules of hyaline cartilage admixed with fibrous adipose tissue, spindle cells, and myxoid stroma ( Figure 11 ). The diagnosis of endobronchial HC was confirmed. Flexible bronchoscopy performed 2 months after patient discharge revealed recurrence of a small yellowish formation, which reduced the lumen by 50% and was completely resected with biopsy forceps. Histological examination revealed an ulcerated bronchial mucosa seat of a hyperplastic fleshy bud, without signs of specificity or malignancy. No recurrence was observed after a follow-up period of 12 months. Figure 7. Flexible bronchoscopy findings: A yellowish polylobed budding formation obstructing completely the middle lobe bronchus. Figure 8. Chest CT-scan: Endobronchial lesion of fatty density in the middle lobe bronchus, responsible for minimal bronchiectasis. Figure 9. Rigid bronchoscopy findings: The tumor occludes the middle lobe bronchus and protrudes into the bronchus intermedius. Figure 10. Macroscopic examination: 2 yellowish smooth fragments measuring 1.5*1.5*0.5 cm long axis. Figure 11. Histopathological examination. A: Hyaline cartilage admixed with variable amounts of fibro adipose tissue, some spindle cells and myxoid stroma. B: Nodules of hyaline cartilage interspersed with spindle cells and myxoid stroma. 3. Discussion Tracheobronchial endoluminal localization of HC is rare. 1 , 2 In a previous paper reviewing 185 cases of benign tumors of the tracheobronchial tree, HC was found in 8.1% of the cases. 3 HC is most frequently diagnosed in individuals between the sixth and seventh decades of life, with a higher prevalence in males. 4 Rare pediatric cases have been described, including one case in a three-and-a-half-month-old child. 5 Histologically, it is a tumor derived from peribronchial mesenchymal tissue, consisting of an absolute disorder and variable proportions of cartilage, junctional tissue, fat, smooth muscle, and respiratory epithelium. Abnormalities in the karyotype of mesenchymal cells have been reported. The most frequent rearrangement affects the 12q15 band of the HMGIC gene. 6 Clinical presentation due to the tracheobronchial localization of the HC is usually very noisy, either directly related to the trachea or the bronchial obstruction; in this case, the patient can be wrongly treated as asthma or COPD, as in our first patient, either in relation to its consequences, in particular obstructive pneumonia or destruction of the lung parenchyma with bronchiectasis, as in our second patient. The patient can also consult for hemoptysis if the tumor erodes a vessel. In the series by Zehani-Kassar et al., all patients were symptomatic, with general signs in four of the seven patients. 4 In view of the small size of the tumor at the time of diagnosis, conventional radiography is not of much help, but can show nonspecific signs such as atelectasis, pneumonia, and bronchiectasis. CT-scan is the imaging modality of choice that identifies pathognomonic signs of intralesional fat and calcifications with variable proportions. 7 On bronchoscopy, the appearance is highly suggestive of a benign tumor. HC presents as a well-circumscribed, polypoid, or pedunculated exophytic tumor with smooth mucosa without evidence of submucosal infiltration, usually located at the origin of a large-calibre bronchi. Its consistency is cartilaginous, but more lipomatous in the endobronchial form. 8 The traditional management of HC involved surgical resection. However, with advancements in endoscopic techniques, minimally invasive approaches have emerged as promising alternatives. These techniques offer several advantages including reduced morbidity, shorter hospital stay, and faster recovery times. 3 Surgery is currently indicated only in cases where the HC is inaccessible or when lung resection is necessary because of irreversible parenchymal damage due to longstanding airway obstruction. 7 In our second patient, endoscopic treatment was preferred despite the presence of bronchiectasis to preserve respiratory function in view of the history of right lower lobectomy, especially that bronchiectasis was minimal. Generally, the endoscopic approach involves rigid bronchoscopy with laser photocoagulation, electrocautery, or argon plasma coagulation, and mechanical resection. 7 Nd-YAG laser is the most widely used technique because of its sufficient power to vaporize tissues and its excellent coagulation effect. 3 However, it’s large and expensive. Diode laser, which is more compact and easier to handle, showed a clinical effect like that of a conventional Nd-YAG laser and can be a useful and safe alternative. 9 For residue removal, cryotherapy is a perfect choice with a lower risk of complications than photocoagulation laser. 8 Finally, for inaccessible segmental HC, gas jet ionized argon plasma coagulation is more suitable, allowing a noncontact treatment mode. 8 Generally, complications are minimal and endoscopic treatment is successful. 3 The prognosis of tracheobronchial HC is considered favorable. The local recurrence rate is low. In a series of seven patients published by Zehani-Kassar et al., no recurrence was noted, with a mean follow-up of 7 years. 4 In the series published by Casío et al., recurrence occurred in four out of 43 patients. 10 There is currently no consensus regarding the follow-up. The long-term follow-up did not reveal any evidence of malignant transformation. 11 In the 2 present cases, there was no evidence of recurrence by flexible bronchoscopy with a stable tumor residue in the first patient. 4. Conclusion Owing to improvements in interventional endoscopy techniques, the endoscopic treatment of tracheobronchial endoluminal HC has become the reference treatment. Even in cases of recurrence or incomplete resection, endoscopic treatment offers favorable results. Surgery is reserved for specific indications. Ethics Ethical approval was not required. Consent Written informed consent was obtained from the two patients for the publication of this case report and associated images. Data availability No data are associated with this article. Acknowledgment We would like to thank Pr Jean Michel Vergnon, Pulmonology Department, Saint Etienne University Hospital, France, for his precious contribution in our interventional bronchoscopy training. References 1. Grabenwöger F, Bardach G, Mohl W: Roentgen morphology and clinical picture of pulmonary hamartochondroma. Rontgenblatter. 1985 Mar; 38 (3): 72–76. 2. Gjevre JA, Myers JL, Prakash UBS: Pulmonary Hamartomas. Mayo Clin. Proc. 1996 Jan 1; 71 (1): 14–20. Publisher Full Text 3. Shah H, Garbe L, Nussbaum E, et al. : Benign Tumors of the Tracheobronchial Tree. Chest. 1995 Jun; 107 (6): 1744–1751. Publisher Full Text 4. Zehani-Kassar A, Ayadi-Kaddour A, Marghli A, et al. : Clinical characteristics of resected bronchial hamartoma. Study of seven cases. Rev. Mal. Respir. 2011 May; 28 (5): 647–653. PubMed Abstract | Publisher Full Text 5. Jain V, Goel P, Kumar D, et al. : Endobronchial chondroid hamartoma in an infant. J. Pediatr. Surg. 2009 Sep; 44 (9): e21–e23. PubMed Abstract | Publisher Full Text 6. Fletcher JA, Longtine J, Wallace K, et al. : Cytogenetic and histologic findings in 17 pulmonary chondroid hamartomas: evidence for a pathogenetic relationship with lipomas and leiomyomas. Genes Chromosomes Cancer. 1995 Mar; 12 (3): 220–223. PubMed Abstract | Publisher Full Text 7. Suzuki M, Watanabe H, Hashimoto M, et al. : Endobronchial hamartoma resected via bronchoscopy using high-frequency electrosurgical snare-Preoperative strategies using virtual bronchoscopy. Radiol. Case Rep. 2022 Nov; 17 (11): 4232–4238. PubMed Abstract | Publisher Full Text 8. Bouazra H, Loukil M, Bouzaidi K, et al. : Endobronchial hamartochondroma. Rev. Mal. Respir. 2013 Nov; 30 (9): 801–805. PubMed Abstract | Publisher Full Text 9. Tanaka K, Nakajima T, Inage T, et al. : Clinical experience of transbronchoscopic laser ablation for central airway stenosis using a high-power diode laser-ten years’ experience at a single institute. Ann. Palliat. Med. 2022 May; 11 (5): 1644–1648. PubMed Abstract | Publisher Full Text 10. Cosío BG, Villena V, Echave-Sustaeta J, et al. : Endobronchial hamartoma. Chest. 2002 Jul; 122 (1): 202–205. Publisher Full Text 11. Sinner WN: Fine-needle biopsy of hamartomas of the lung. AJR Am. J. Roentgenol. 1982 Jan; 138 (1): 65–69. PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 14 Jan 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of Respiratory Diseases and Interventional Endoscopy, Pavillon 2, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia 2 Faculty of Medicine of Tunis, Research Laboratory LR12SP04, Tunis El Manar University, Tunis, Tunis, Tunisia 3 Department of Pathology, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Ariana, Tunisia 4 Department of Anesthesiology and Critical Care, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Ariana, Tunisia 5 Department of Radiology, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Ariana, Tunisia Amany Touil Roles: Data Curation, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Maazaoui Sarra Roles: Data Curation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Darragi Karim Roles: Data Curation, Visualization, Writing – Original Draft Preparation Chaabane Mariem Roles: Visualization, Writing – Original Draft Preparation Znegui Tasnim Roles: Visualization, Writing – Original Draft Preparation Ayadi Rahma Roles: Data Curation, Visualization, Writing – Original Draft Preparation Fitouhi Nizar Roles: Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Baccouche Ines Roles: Data Curation, Writing – Original Draft Preparation Racil Hager Roles: Supervision, Validation Chaouch Nawel Roles: Supervision, Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 14 Oct 2025, 14:76 https://doi.org/10.12688/f1000research.159445.2 version 1 Published: 14 Jan 2025, 14:76 https://doi.org/10.12688/f1000research.159445.1 Copyright © 2025 Touil A et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Touil A, Sarra M, Karim D et al. Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.12688/f1000research.159445.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 14 Jan 2025 Views 0 Cite How to cite this report: Peris SC. Reviewer Report For: Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.5256/f1000research.175169.r383632 ) The direct URL for this report is: https://f1000research.com/articles/14-76/v1#referee-response-383632 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 May 2025 Selene Cuenca Peris , General University Hospital of Castellon, Castellon, Spain Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.175169.r383632 This article describes two cases of Tracheobronchial endoluminal hamartochondroma treated with rigid bronchoscopy. In addition, a review of the pathology and its approach is made and the advantages of bronchoscopy versus surgery are described. This is a ... Continue reading READ ALL This article describes two cases of Tracheobronchial endoluminal hamartochondroma treated with rigid bronchoscopy. In addition, a review of the pathology and its approach is made and the advantages of bronchoscopy versus surgery are described. This is a very interesting paper that complies with the journal's standards but requires some changes before indexing. In the introduction, the bibliography of the statements described is missing. In the description of the cases, a more detailed description of the laser technique applied (including power, time, etc.) and whether other instruments were used to remove the lesion (forceps, cryobiopsy, etc.) is missing. In case 2, I would change the phrase “Past medical history” to just medical history. In the text of Figure 2 there is no description of what projection each letter corresponds to. In Figure 8, the description of each letter is missing. Discussion, conclusions and bibliography is okay. Is the background of the cases’ history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the conclusion balanced and justified on the basis of the findings? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: interventional pulmonology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Peris SC. Reviewer Report For: Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.5256/f1000research.175169.r383632 ) The direct URL for this report is: https://f1000research.com/articles/14-76/v1#referee-response-383632 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 14 Jan 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 2 (revision) 14 Oct 25 read read read Version 1 14 Jan 25 read Selene Cuenca Peris , General University Hospital of Castellon, Castellon, Spain Paolo Scanagatta , Hospital Eugenio Morelli, Morelli, Italy Akesh Thomas , Prisma Health Greenville Memorial Medical Campus Department of Psychiatry & Behavioral Medicine, Greenville, USA Ummi Nadira Daut , Universiti Putra Malaysia, Serdang, Malaysia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Daut U. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 14 Nov 2025 | for Version 2 Ummi Nadira Daut , Universiti Putra Malaysia, Serdang, Malaysia 0 Views copyright © 2025 Daut U. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions For the case report, please ensure the bronchoscopy images consistently arranged orientation and suggest to put arrow to the abnormal finding (Rt vs Lt) Your discussion currently explains what happened; however lacking on explanation why it matters and what is the implications for future diagnosis or therapy. Detail the on the management rationale , explaining why you chose endoscopic management over surgery, and was snare electrocautery being used? Is the background of the cases’ history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the conclusion balanced and justified on the basis of the findings? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise asthma phenotyping and biomarkers (FeNO, eosinophils, Vitamin D, and tocotrienols), COPD comorbidities and quality of life, tuberculosis diagnostics and public health engagement, pleural and airway intervention studies, including advanced bronchoscopy and pleuroscopy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Daut UN. Peer Review Report For: Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.5256/f1000research.189414.r430247) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-76/v2#referee-response-430247 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Thomas A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 13 Nov 2025 | for Version 2 Akesh Thomas , Prisma Health Greenville Memorial Medical Campus Department of Psychiatry & Behavioral Medicine, Greenville, South Carolina, USA 0 Views copyright © 2025 Thomas A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors are describing two cases of pulmonary hamartochondroma in this case series. The cases are well defined along with their presentaiton and the treatment they have done. Case 1 "The patient was subsequently hospitalized for bilateral hypoxemic pneumonitis and acute respiratory failure, which was treated as COPD exacerbation with a good evolution under usual treatment." - This sentence can be changed for better clarity. Pneumonitis is a rather non-specific description here. Are flow-volume loops available for this patient? Do not agree with the description of hypo-dense lesion on CT it would be better to specify the exact Hounsfield units if available. Case 2 The flow volume loop will be interesting in this case, also if available Discussion "Clinical presentation due to the tracheobronchial localization of the HC is usually very noisy." ; Please make clarity in this sentence. Is the author saying the clinical presentation is of noisy breathing, like a stridor, or are they saying the presentation is noisy as non non-specific presentation? Is the background of the cases’ history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the conclusion balanced and justified on the basis of the findings? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Bronchoscopy, General Pulmonology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Thomas A. Peer Review Report For: Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.5256/f1000research.189414.r430252) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-76/v2#referee-response-430252 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Scanagatta P. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 29 Oct 2025 | for Version 2 Paolo Scanagatta , Hospital Eugenio Morelli, Morelli, Italy 0 Views copyright © 2025 Scanagatta P. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Summary & rationale: The manuscript presents two well-documented cases of tracheobronchial endoluminal hamartochondroma treated with laser-assisted rigid bronchoscopy. The revision addresses the earlier reservations: the Introduction now includes appropriate citations; laser parameters and devices are specified for both cases; whether additional tools were used is clarified; and figure captions/panel labels have been corrected. The cases are clinically meaningful, the endoscopic approach is described clearly, and outcomes and follow-up are adequate. Overall, the article meets the journal’s standards for indexing. Minor, non-blocking suggestions Ensure uniform terminology throughout (use one term consistently: “hamartochondroma” vs “hamartoma”). Consider adding the follow-up duration for both cases in the Abstract for immediacy. Do a final proof for a few small typos/spacing issues in figure captions. Is the background of the cases’ history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the conclusion balanced and justified on the basis of the findings? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Interventional pulmonology / thoracic surgery. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Scanagatta P. Peer Review Report For: Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.5256/f1000research.189414.r424923) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-76/v2#referee-response-424923 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Peris S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 May 2025 | for Version 1 Selene Cuenca Peris , General University Hospital of Castellon, Castellon, Spain 0 Views copyright © 2025 Peris S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This article describes two cases of Tracheobronchial endoluminal hamartochondroma treated with rigid bronchoscopy. In addition, a review of the pathology and its approach is made and the advantages of bronchoscopy versus surgery are described. This is a very interesting paper that complies with the journal's standards but requires some changes before indexing. In the introduction, the bibliography of the statements described is missing. In the description of the cases, a more detailed description of the laser technique applied (including power, time, etc.) and whether other instruments were used to remove the lesion (forceps, cryobiopsy, etc.) is missing. In case 2, I would change the phrase “Past medical history” to just medical history. In the text of Figure 2 there is no description of what projection each letter corresponds to. In Figure 8, the description of each letter is missing. Discussion, conclusions and bibliography is okay. Is the background of the cases’ history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the conclusion balanced and justified on the basis of the findings? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise interventional pulmonology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Peris SC. Peer Review Report For: Tracheobronchial endoluminal hamartochondroma resected via rigid bronchoscopy: 2 case reports of a rare entity [version 1; peer review: 1 approved with reservations] . F1000Research 2025, 14 :76 ( https://doi.org/10.5256/f1000research.175169.r383632) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-76/v1#referee-response-383632 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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