Role of bronchoscopic intervention in endobronchial mesenchymal tumours – A retrospective study and systematic review of literature

Background: Primary pulmonary mesenchymal tumours (PMTs) are rare, and their management strategies are heterogeneous due to the lack of standardised treatment protocols. Given the morbidity associated with surgical resection, less invasive therapeutic options are warranted. Therefore, we aimed to assess the role of bronchoscopic interventions in endobronchial PMTs. Methods: We retrospectively reviewed the records (January 2018 to June 2025) of patients who underwent bronchoscopic intervention for endobronchial PMT. We evaluated the clinical characteristics, feasibility, complication rates and follow-up outcomes of bronchoscopic interventions. A systematic review of the literature was performed to identify all reported adult patients who underwent bronchoscopic intervention, enabling comparison with our case series. Results: Eighteen patients (12 males) with a mean age of 40.0 ± 15.2 years (range, 18–67) underwent bronchoscopic interventions. Dyspnoea (83.4%), cough (72.2%) and chest pain (44.5%) were the most common presenting symptoms, while stridor was present in 10 (55.6%) patients. Despite central airway obstruction, the mean duration of symptoms prior to diagnosis was 7.6 ± 8.6 months (range 2–34). Bronchoscopic interventions successfully achieved >90% luminal patency after lesion removal in most patients. These results are consistent with our accompanying systematic review of 152 reports, which synthesised a comparative literature cohort of 204 patients across four primary mesenchymal tumour subtypes. Conclusion: Bronchoscopic interventions represent a feasible, effective and low-risk approach for immediate and lasting relief of airway obstruction in PMTs. They can be considered in selected patients, potentially obviating the need for a conventional surgical approach.