Reactions 1704, p85 - 2 Jun 2018
Bronchomediastinal fistula: case report
The 54-year-old man developed bronchomediastinal fistula
during chemotherapy with carboplatin and paclitaxel [taxol]
for squamous cell lung cancer.
The man, who had squamous cell lung cancer, underwent
lower left lobectomy. One year later, he presented recurrence
at the ganglion level and received chemotherapy and
radiotherapy for three months. After one year of stabilisation,
he developed haemoptysis with relapse in the posterior wall of
the main right bronchus. Consequently, he was started on
carboplatin [route and dosage not stated] and paclitaxel.
Approximately one month after the last cycle of
chemotherapy, he presented to the emergency department
because of progressive dyspnoea and was hospitalised.
Radiological findings revealed adenopathic mass-
conglomerate of necrotic appearance at the right parahilar and
subcarinal mediastinal level along with a fistulous tract that
communicated necrotic subcarinal lymphadenopathies with
the bronchus intermedius. Flexible bronchoscopy confirmed
the neoplastic involvement with broncho-mediastinal fistula in
the bronchus intermedius posterior wall.
Ten days later, the man’s fistula was sealed by rigid
bronchoscope with bovine serum albumin/glutaral under
general anaesthesia. During examination, the previous
fistulous opening was not visible, which had closed
spontaneously. Fourteen days after admission, he was
discharged home with clinical improvement; however, he
required home oxygen therapy and follow-up by the palliative
unit. Two months later, he died at home because of overall
deterioration secondary to the evolution of his neoplastic
Author comment: "Tracheomediastinal fistulas appear
mainly related to lung cancer, and particularly to lymphoma,
appearing secondary to necrosis caused by chemotherapy or
radiotherapy in adenopathies in close contact with the
Hurtado EJS, et al. Bronchomediastinal fistula with spontaneous resolution in a
patient with lung cancer. Current Respiratory Medicine Reviews 13: 178-181, No.
3, Sep 2017. Available from: URL: http://
doi.org/10.2174/1573398X13666170522183920 - Spain
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved