PMC9364020_01
CT showed subcarinal tumor invading into the carina.
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A chest computed tomography (CT) showed that the patient had a 4.7 cm x 6.5 cm subcarinal tracheal mass invading into the carina, lower portion of the trachea, and main stem bronchus (Fig. 1).
PET showed hypermetabolic subcarinal mass.
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The positron emission tomography (PET) scan revealed hypermetabolic subcarinal mass (standardized uptake value [SUV] 50.0), gastrohepatic node (SUV 4.0), and focal hypermetabolism in the left paraspinous muscle (SUV 8.1) (Fig. 2).
The flexible bronchoscopy showed the tumor right above the carina.
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The tumor completely occluded the left main stem bronchus and caused approximately 95% occlusion of the right main stem bronchus (Fig. 3).
Tumor debulking with ECMO support.
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The rigid bronchoscopy with tumor debulking was reattempted and successful with VV ECMO support (Fig. 4).
Y stent was placed (trachea view).
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A customized Y stent extending 2.5 cm into the right main stem bronchus and 4.5 cm into the left main stem bronchus was also placed in the trachea and main stem bronchi (Fig. 5, Fig. 6).