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Ann Thorac Surg 2006;82:e22-e23
© 2006 The Society of Thoracic Surgeons

Case report

Topical Mitomycin-C for Obstructing Endobronchial Granuloma

Alvin Penafiel, MD, Pyng Lee, MD*, Anne Hsu, MD, FCCP, Philip Eng, MD, FCCP

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore

Accepted for publication May 10, 2006.

* Address correspondence to Dr Lee, Department of Respiratory and Critical Care Medicine Singapore General Hospital, Outram Road, Singapore 169608 (Email: lee.pyng{at}sgh.com.sg).

An elderly woman with post-tuberculous stricture of the lower trachea and main bronchi underwent laser re-canalization, balloon dilation, and silicone stent insertion in the lower trachea and main bronchi. Subsequently she had recurrent dyspnea develop due to obstructing granulomas, which necessitated four endoscopic procedures in 2 years. The tracheal stent was removed and topical mitomycin-C was applied using saturated pledgets at a dose of 0.5 mg/mL for 2 minutes each over the lower trachea and both orifices of the main bronchi. Follow-up for 24 months showed no recurrence of symptoms. Bronchoscopy and spirometry performed at 2, 6, and 12 months showed resolution of the granulomas.




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