Bronchoscopic cryosurgery for metastatic tumor causing central airway obstruction: A case report

This report describes the interventional bronchoscopic cryotherapy for a patient with CAO caused by squamous cell carcinoma of the esophagus. We display a series of dramatic change of chest radiographs before and after the intervention. Patient concerns: A 70-year-old man with squamous cell carcinoma of the middle third of the esophagus (initial staging, pT2N0M0; stage IIB; in January 2017) underwent Video-assisted esophagectomy and reconstruction with a gastric conduit via a substernal route. Following Chest computed tomography and positron emission tomography revealed disease progression with paratracheal metastases. Progressive dyspnea and chest pain lasted for a month, and he was admitted to the ER. Diagnoses: Blood gas analysis revealed type I respiratory failure (pH, 7.445; PaO2, 69.4 mmHg; PaCO2, 40.6 mmHg). Other laboratory data were grossly normal. Chest radiography revealed a total left lung collapse. Chest CT identified a tumor blocking the left mainstem bronchus with the consolidation of the left lung. Interventions: Dexamethasone and epinephrine inhalation were administered for initial symptom relief. Bronchoscopy performed 4 days after admission revealed a huge tumor completely occluding the left mainstem bronchus orifice. The occlusion was completely resolved following cryotherapy. Then, the first course of palliative chemotherapy with cisplatin plus fluorouracil, followed by the second course a month later, was administered. Outcomes: The latest ch...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research