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
Abstract Views: 242
PDF: 114
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Kouritas VK, Papagiannopoulos K, Lazaridis G, et al. Pneumomediastinum. J Thorac Dis. 2015;7:S44-9.
Gustafsson BI, Kidd M, Chan A, et al. Bronchopulmonary neuroendocrine tumors. Cancer. 2008 ;113:5-21. DOI: https://doi.org/10.1002/cncr.23542
Zahid M, Shafiq I, Albon L, Kause J. Typical bronchial carcinoid tumour presenting as pneumomediastinum. BMJ Case Rep. 2011;2011:bcr0120113744. DOI: https://doi.org/10.1136/bcr.01.2011.3744
Biçer EN, Öztürk AB, Ozyigit LP, et al. A case of uncontrolled severe asthma patient with coexisting carcinoid tumor presenting as pneumomediastinum. J Asthma. 2015;52:1095-8. DOI: https://doi.org/10.3109/02770903.2015.1054402
Ammouri Z, Idelhaj N, Boubia S, Ridai M. spontaneous bilateral pneumothorax and pneumomediastinum revealing a bronchial carcinoid tumor. Clin Surg. 2019;4:2547.
Biolo M, Salton F, Ruaro B, et al. Emergency laser treatment of a tracheobronchial carcinoid during ECMO. Medical Research Archives 2020;8:1-8. DOI: https://doi.org/10.18103/mra.v8i8.2212
Nicholson AG, Tsao MS, Beasley MB, et al. The 2021 WHO classification of lung tumors: impact of advances since 2015. J Thorac Oncol. 2022;17:362-87. DOI: https://doi.org/10.1016/j.jtho.2021.11.003
Macklin MT, Macklin CC. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: an interpretation of the clinical literature in the light of laboratory experiment. Medicine 1944;23:281-358. DOI: https://doi.org/10.1097/00005792-194412000-00001
Macia I, Moya J, Ramos R, et al. Spontaneous pneumomediastinum: 41 cases. Eur J Cardiothorac Surg 2007;31:1110-4. DOI: https://doi.org/10.1016/j.ejcts.2007.03.008
Caceres M, Ali SZ, Braud R, et al. Spontaneous pneumomediastinum: a comparative study and review of the literature. Ann Thorac Surg 2008;86:962-6. DOI: https://doi.org/10.1016/j.athoracsur.2008.04.067
Sakai M, Murayama S, Gibo M, et al. Frequent cause of the Macklin effect in spontaneous pneumomediastinum: demonstration by multidetector-row computed tomography. J Comput Assist Tomogr. 2006;30:92-4. DOI: https://doi.org/10.1097/01.rct.0000187416.07698.8d
Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. Eur J Cardiothorac Surg. 2004;25:852-5. DOI: https://doi.org/10.1016/j.ejcts.2004.01.042
Davila DG, Dunn WF, Tazelaar HD, Pairolero PC. Bronchial carcinoid tumors. Mayo Clin Proc. 1993;68:795-803. DOI: https://doi.org/10.1016/S0025-6196(12)60641-7
Ruggieri M, Scocchera F, Genderini M,et al. Therapeutic approach of carcinoid tumours of the lung. Eur Rev Med Pharmacol Sci. 2000;4:43-6. DOI: https://doi.org/10.1016/S0169-5002(00)80520-6

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
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.