Tracheal restenosis after removal of long-term placed Ultraflex expandable metallic stents

Abstract

Restenosis of trachea after stent placement and removal in patients with malignant airway obstruction has rarely been reported. Here, we reported a 47-year-old woman with large B cell lymphoma at the mediastinum. It was obstructing the trachea and left main bronchus. Two Ultraflex expandable metallic stents were placed immediately due to acute respiratory distress. She underwent concurrent chemoradiotherapy for the lymphoma with good response. Because granulation tissue overgrew the upper margin of the trachea stent and caused frequent sputum impaction, stents were removed after 21 months. Dyspnea developed 8 months later. Bronchoscopy revealed restenosis from granulation tissue and fibrosis at the previous upper margin of the trachea stent. Segmental resection of trachea with primary anastomosis was performed and the patient recovered. Thus, tracheal restenosis may still occur in malignant obstruction patient undergoing Ultraflex stents insertion. Surgery remains a feasible treatment if underlying malignancy is in remission.