Use of cryotherapy to treat obstructing papilloma of an accessory tracheal bronchus: case report

Abstract

Background: Tracheal papillomatosis is a relatively rare condition with limited data on successful treatment modalities. To our knowledge, this is the first report to describe a papilloma arising from an accessory bronchus. Furthermore, this case report demonstrates successful treatment with clinical and patient-centered improvements after use of Spray Cryotherapy.

Case presentation: A 71-year-old woman presented with one year history of recurrent fevers and intermittent hemoptysis. Imaging and video bronchoscopy revealed an obstructing papilloma of an accessory tracheal bronchus to the right upper lobe. She was treated with debridement followed by multiple cryotherapy treatments resulting in complete clinical and radiographic resolution of her post-obstructive pneumonia.

Conclusions: This case report not only supports existing literature on the use of cryotherapy for airway diseases but also presents a unique form of obstructing papilloma confined to an accessory bronchus, the only report of its kind based on extensive literature review.

Keywords: Bronchoscopy/bronchus; Case report; Cryotherapy; Tracheal; Tumor.

Fig. 1

CT chest, axial, comparing multi-loculated lesion in right upper lobe before (a) and after treatment (b)

Fig. 2

CT scan, coronal, comparing obstructed accessory bronchus before treatment (a) and patent bronchus after treatment (b)

Fig. 3

Image taken during bronchoscopy showing large papilloma obstructing accessory bronchus (a), application of cryotherapy to area (b), and patent airway after most recent cryotherapy treatment (c)