https://doi.org/10.4081/ecj.2024.12651

Pneumomediastinum as a manifestation of a bronchial carcinoid tumour: a very rare association of two uncommon diseases

Vol. 20 No. 3 (2024)
Submitted: 9 May 2024
Accepted: 7 August 2024
Published: 26 August 2024
Bronchial carcinoid tumour, pneumomediastinum, Macklin effect, Computed Tomography, bronchoscopy, thoracic surgery, thorax, chest
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Authors

Massimo Barakat
massimo.barakat@gmail.com
https://orcid.org/0009-0002-4851-9955
Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Costanza De Santis
Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Gabriella Zafarana
Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Ludovica Lotrecchiano
Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Thomas Galasso
Interventional Pulmonology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Piero Candoli
Interventional Pulmonology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Piergiorgio Solli
Thoracic Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Niccolò Daddi
Thoracic Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna; Alma Mater Studiorum, Department of Medical and Surgical Sciences, University of Bologna, Italy.

A 29-year-old man presented to the emergency department with haemoptysis and thoracic pain. His vital signs and blood tests were normal, except for increased C-reactive protein levels. Fibrolaryngoscopy and esophagogastroduodenoscopy results were negative. Computed Tomography of the chest revealed abundant pneumomediastinum, air dissection along the peribronchovascular sheaths of the left lower lobe and a vegetating lesion completely occluding the distal extremity of the left main bronchus. After complete bronchoscopic excision of the lesion, histological examination revealed a carcinoid tumour not otherwise specified. After hospital discharge, 18F-fluorodeoxyglucose and 68Ga-DOTANOC positron emission tomographies ruled out distant metastases. A sleeve resection of approximately 20 mm of the distal extremity of the left main bronchus and a circumferential anastomosis between the left main bronchus and ipsilateral lobar bronchi were performed. Several bronchoscopic follow-ups did not show anastomotic dehiscence or tumour relapse.

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How to Cite

Barakat, M., De Santis, C., Zafarana, G., Lotrecchiano, L., Galasso, T., Candoli, P., Solli, P., & Daddi, N. (2024). Pneumomediastinum as a manifestation of a bronchial carcinoid tumour: a very rare association of two uncommon diseases. Emergency Care Journal, 20(3). https://doi.org/10.4081/ecj.2024.12651
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