Emergent airway recanalization of the left main bronchus due to obstructive adenoid cystic carcinoma enables achievement of radical resection

Respirol Case Rep. 2023 Dec 6;12(1):e01268. doi: 10.1002/rcr2.1268. eCollection 2024 Jan.

Abstract

Malignant airway obstruction is a life-threatening condition that can cause suffocation and recurrent infections due to lung atelectasis. Adenoid cystic carcinoma is a rare and slow-growing tumour of low-grade malignancy. We report the case of a 69-year-old female who presented with severe chest pain, orthopnea, and a 1-month history of progressively worsening difficulty in breathing. Emergent rigid bronchoscopy revealed a polypoid tumour originating in the proximal end of the left main bronchus that was obstructing the left main bronchus. Debulking of the tumour using rigid bronchoscopy was performed to restore ventilation to collapsed lung and obtain histopathological examination. Histological analysis revealed a diagnosis of adenoid cystic carcinoma. The patient underwent radical sleeve resection of the left main bronchus without sacrificing lung parenchyma via left posterolateral thoracotomy. No postoperative complications or disease recurrence was found at the 5-year follow-up. This case emphasizes the pivotal role of rigid bronchoscopic intervention in malignant central airway obstruction.

Keywords: adenoid cystic carcinoma; bronchoplasty; rigid bronchoscopy.

Publication types

  • Case Reports