PMC7305424_01
Computed tomography (CT). a. Chest CT image obtained after the initial diagnosis of endobronchial metastasis. CT revealed the presence of a tumor in the posterior wall of the upper portion of the trachea. b. Chest CT image obtained 3 months after the initial diagnosis of endobronchial metastasis. CT revealed that the size of the tumor had increased.
gr1.jpg
PMC7305424_01_gr1.jpg
fig1
Chest CT revealed a tumorous lesion slightly protruding in the trachea (Fig. 1).
Computed tomography (CT) and endoscopic images obtained 6 months after the initial diagnosis of endobronchial metastasis. a. Horizontal section view of chest CT image. The border between the tumor and esophagus is unclear and tumor invasion to the esophagus is suspected (a white arrow). b. Sagittal section view. c. Frontal section view. CT revealed tumor progression. d. Endoscopic view. The tumor caused narrowing of the tracheal lumen by about two-third. The tumor appeared to be pedunculated and had developed in the right side of the tracheal membranous portion.
gr2.jpg
PMC7305424_01_gr2.jpg
fig2
The size of the mass increased, and the patient was referred to our department (Fig. 2a-c). Chest CT revealed the presence of a tumor in the posterior wall of the upper portion of the trachea (Fig. 2a-c). In addition, the part of the border between the trachea and esophagus was not distinct (Fig. 2a-c). However, the distal part of trachea could still be examined (Fig. 2d).
Computed tomography (CT) and endoscopic images obtained 2 months after the initial bronchial intervention. a. Horizontal section view of chest CT image. b. Sagittal section view. CT revealed that most of the tumor had been removed. c. Endoscopic view. The tracheal lumen was re-established via bronchial intervention.
gr3.jpg
PMC7305424_01_gr3.jpg
fig3
Finally, tumor reduction was completed using a polypectomy snare (Fig. 3a-c).
Computed tomography (CT) and endoscopic images obtained 8 months after the initial bronchial intervention. a. Horizontal section view of chest CT image. The border between the tumor and esophagus remains unclear and tumor invasion to the esophagus is also suspected (a white arrow). b. Sagittal section view. CT revealed that the size of the tumor had increased again. c. Endoscopic view. The tracheal lumen was narrowed by the tumor, and the endotracheal tumor was of mixed type.
gr4.jpg
PMC7305424_01_gr4.jpg
fig4
However, exacerbation was detected on the same sites 6 months after treatment (Fig. 4a and b).
Chest radiography, computed tomography (CT), and endoscopic images obtained after the stent was placed. a. The stent had expanded sufficiently in the trachea. b. Horizontal section view of chest CT image. b. Sagittal section view. Chest CT revealed that the stent had expanded adequately and that the airway was patent. d. Endoscopic view, proximal view. e. Distal view. The stent had expanded sufficiently in the trachea.
gr5.jpg
PMC7305424_01_gr5.jpg
fig5
Then, the AERO stent (16 x 60 mm, over-the-wire delivery system) was placed (Fig. 5a-e) using a previously described method.