CASE REPORT   

Minerva Respiratory Medicine 2021 December;60(4):155-8

DOI: 10.23736/S2784-8477.21.01953-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

First rigid bronchoscopy in COVID-19 pneumonia to treat a rare endobronchial tumor during extracorporeal membrane oxygenation

Paolo SOLIDORO ^{1, 2}, Vito FANELLI ³, Alessandra PITTARO ⁴, Luisa DELSEDIME ⁴, Mauro PAPOTTI ⁴, Filippo PATRUCCO ^{2, 5, 6} ✉, Massimo BOFFINI ⁷, Mauro MANGIAPIA ¹, Carlo ALBERA ^{1, 2}, Luca BRAZZI ³

¹ Unit of Respiratory Diseases, Department of Cardiovascular and Thoracic, Città della Salute e della Scienza, Turin, Italy; ² Department of Medical Sciences, University of Turin, Turin, Italy; ³ Division of Anesthesia and Critical Care Medicine, Department of Surgical Science, Città della Salute e della Scienza, University of Turin, Turin, Italy; ⁴ Department of Oncology, University of Turin, Turin, Italy; ⁵ Division of Respiratory Diseases, Medical Department, Maggiore della Carità Hospital, Novara, Italy; ⁶ Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy; ⁷ Division of Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy

During the COVID-19 pandemic in Northern Italy, a young man with fever and dyspnea was admitted to the Emergency Department. The sudden development of severe hypoxemia and respiratory acidosis forced the emergency medical team to intubate the patient. Fiberoptic bronchoscopy and chest CT scan showed the presence of a bleeding neoformation, occluding the majority of tracheal lumen requiring the connection to a veno-venous extracorporeal respiratory support. A rigid bronchoscopy was performed to clear the tracheal lumen, obtaining a diagnosis of “composite hemangioendothelioma.” All personnel involved was equipped with personal protective equipment (PPE) and power air-purifying respirators (PAPR). ECMO and mechanical ventilation were soon weaned, lung CT showed an almost complete patency of tracheo-bronchial tree. To the best of our knowledge, this is the first rigid bronchoscopic procedure reported in a SARS-CoV-2 virus pneumonia respiratory failure requiring ECMO, allowing to diagnose an extremely rare endobronchial tumor.

KEY WORDS: Bronchoscopy; COVID-19; Hemangioendothelioma; Personal protective equipment