First bronchoscopic treatment with cryotherapy and argon plasma of squamous cell carcinoma of the lung at the Metropolitan Hospital, Quito, Ecuador

Abstract

Introduction: Endobronchial tumors that cause obstruction are amenable to endoscopic treatment to repermeabilize the airway, improve symptoms and reduce complications. We present a patient with no clinical pathological history who presented chronic productive cough and recurrent pneumonia with a previous bronchoscopy in which an endobronchial lesion was evident that occupied 100% of the lumen of the left main bronchus. She presented with symptoms of fever, tachycardia and with oxygen provision at low flows; with slightly reduced lung expansibility. On auscultation, vesicular murmur abolished in the left lung field and radiologically with massive atelectasis of the left lung and amputation of the left main bronchus. Interventions and results: bronchoscopy was performed with endobronchial tumor debulking using argon plasma (APC) and cryotherapy, a procedure performed for the first time at the Metropolitan Hospital without complications. In the radiological control, re-permeabilization of the airway was observed. The histopathological analysis of the lesion defines the diagnosis of mucoepidermoid carcinoma (MSC) of the lung. Conclusions: Endobronchial lesions present in a non-specific manner and are a therapeutic challenge. Cryotherapy and ablation using APC are available options for reducing tumor volume, repermeabilization of the bronchial lumen, lung reexpansion, symptomatic control and improving the quality of life of patients.