Abstract
A 46-year-old man with liver cirrhosis, who had been operated upon for hepatocellular carcinoma in 1992, developed dyspnea on exertion in April, 1994. He was admitted to our hospital because of atelectasis of the left lower lobe. Bronchofiberscopic examination revealed a large polypoid tumor completely obstructing the orifice of the left main bronchus, and transbronchial biopsy confirmed a diagnosis of adenoid cystic carcinoma. Chest CT showed that the tumor obstructed the left main bronchus. Bronchofiberscopic treatment was preferred because of severe liver dysfunction. Several sessions of bronchofiberscopic Nd-YAG laser and intratumoral injection of ethanol were performed. The obstruction was improved after the spontaneous expectoration of the degenerated and necrotic tissue, and the tumor obstructing the left main bronchus was successfully diminished. During treatment, cough, fever and slight impairment of liver function appeared as the complications of bronchofiberscopic intratumoral injection. We reported a case in which bronchofiberscopic treatment was safe and effective to improve the airway obstruction and diminish the tumor in a patient with a severely cirrhotic liver.
