N. Gomez*a (Dr), JR. Gononga (Dr), D. Teoa (Dr)


* gnoelgomez@gmail.com

Introduction: Endobronchial lesions, especially tumors that fully obstruct the central airways, provide dilemma to interventional pulmonologists. In this case series, three patients with endobronchial obstruction will be discussed.

Cases: Case 1 had an incidental finding of an atelectatic right lung on chest x-ray. Her chest CT scan showed a collapse right lung, with obliterated right mainstem bronchus and enhancing nodular structure extending in the pre-bifurcation region. Case 2 had a recurrent non-productive cough for seven years. He had an incidental radiographic finding of homogenous opacification of the right lower lung field. His chest CT scan showed a heterogenous mass at the right infrahilar region extending to the carina. A partial obstruction of the right mainstem bronchus was also noted. Case 3 had productive cough with associated non-massive hemoptysis and shortness of breath. On chest x-ray, the entire left lung was noted atelectatic. Chest CT scan showed a soft tissue density at the main bronchus. All patients underwent fiberoptic bronchoscopy, cryoablation and cryo-recanalization of the obstructed airway.

Discussion and Conclusion: Cryotherapy is an important diagnostic and therapeutic modality for treatment for lung tumors, especially for tumors causing obstruction to main airways. Patients undergoing cryotherapy can provide immediate relief of obstructive signs and symptoms, can bridge patients in preparation for further definite surgical plans, provide less complications due to less invasive type of procedure, and a treatment option for patients with poor performance status who may not tolerate surgery. Bronchial adenomas, although slow progressing tumor, are still malignant neoplasms and timely detection and treatment by definitive surgical resection is needed to improve long term prognosis. Other treatment modalities like radiotherapy and chemotherapy are still under investigation.

Disclosure of funding source(s): none