Management of Tracheal Stent Granulations: A Novel Approach

Abstract

This is a case of a 29 year old female, diagnosed with adenoid cystic carcinoma of trachea who had previously undergone bronchoscopy, de-bulking of the tumour, stenting of trachea with a metallic stent followed by a course of chemo-radiotherapy. She then presented to our hospital with complaints of breathing difficulty. On rigid telescopy of larynx, a metallic stent was visualised below the level of the vocal cords with a mass lesion over it narrowing the airway. Contrast enhanced CT scan of neck and thorax showed a tracheal stent with soft tissue thickening at proximal and distal ends. By using VV-ECMO, in this patient we were able to perform satisfactory airway evaluation, biopsy of mass at upper and lower end of tracheal stent using a rigid bronchoscope with Hopkins telescope and optical forceps and KTP laser assisted excision of granulation tissue with full endoscopic visualisation and without any complications.