Otolaryngologie : accès libre

Abstrait

The Sequential Interventional Treatment of a Case of Right-Sided Lung Cancer with Atelectasis

Wu Gang, Li Zong-Ming, Han Xin-Wei, Wang Zhong-Gao, Jiao De-Chao, Ren Ke-Wei,  Zhu Ming

Lung cancer combined with severe airway stenosis is a medical emergency, and unlike mild-to-moderate stenosis, is difficult to treat with percutaneous or bronchoscopic biopsy and stenting. We report the successful treatment of a case of lung cancer with severe airway stenosis that was treated sequentially with initial airway angiography, forceps biopsy using interventional radiology, stent placement, regional perfusion chemotherapy through a bronchial artery and radiotherapy. A 66 year-old male patient presented with a 1-month history of a productive cough, with dyspnea in the preceding 6 days. A chest spiral CT scan showed obstruction of the right hilum and complete right lung atelectasis with plugging of the right main bronchus. The patient was initially managed with oxygen before undergoing airway angiography and biopsy. A Y-shaped stent was placed through the affected bronchus, which alleviated the atelectasis. The patient further responded to locally-delivered chemotherapy and regional radiotherapy. After two years of follow-up, the patient was still alive, and no longer breathing difficultied, chest CT review showed that the tumor was no significant progress. Sequential therapy with a range of interventions can lead to an improved quality of life and a prolonged survival duration in a patient with an acute presentation of severe airway stenosis.