Tuberc Respir Dis.  2014 Nov;77(5):215-218. 10.4046/trd.2014.77.5.215.

Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

• Han YH
• Jung BH
• Kwon JS
• Lim J

• KMID: 2050714
• DOI: http://doi.org/10.4046/trd.2014.77.5.215

Abstract

Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

Keyword

Thyroid Neoplasms; Trachea; Bronchoscopy; Aged; Neoplasm Invasiveness; Endotracheal Intubation

MeSH Terms

Aged, 80 and over
Airway Obstruction
Anesthesia, General
Argon Plasma Coagulation
Bronchoscopes
Bronchoscopy
Dilatation
Disulfiram
Dyspnea
Female
Humans
Inflation, Economic*
Intubation, Intratracheal
Neoplasm Invasiveness
Respiratory Insufficiency
Stents
Thyroid Neoplasms*
Trachea
Vocal Cords
Disulfiram

Figure

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  Figure 1 (A, B) Chest computed tomography (CT) at admission. Chest CT showing a endotracheal mass obstructing upper trachea (arrows).

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  Figure 2 Bronchoscopic findings during procedure. Initial finding of upper trachea showing near total obstruction (A), tracheal luminal widening after endotracheal tube balloon inflation with bronchoscopic guidance (B), after argon plasma coagulation (C).

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