Right Internal Mammary Artery Embolization Before Interventional Bronchoscopy to Avoid Massive Hemoptysis in a Case of Adenoid Cystic Carcinoma Originating in the Trachea

Abstract

Background. We report a case of adenoid cystic carcinoma originating in the trachea, treated with transcutaneous arterial embolization (TAE) before the bronchoscopic tumor removal procedure. Case. An 84-year-old man with a tracheal tumor was referred to our hospital. The tumor had already been diagnosed as adenoid cystic carcinoma at another hospital. Although we planned to remove the tumor, we were concerned that the removal procedure might cause massive bleeding because the tumor was markedly stained in his enhanced chest computed tomography. Moreover, the doctor, who diagnosed the patient's tracheal tumor, informed us it was difficult to stop bleeding during bronchoscopic biopsy at the original hospital. Thus TAE was performed before tumor removal. The feeding artery was one of the branches of his right internal mammary artery. After the arterial embolization, the tumor was removed safely with only minor bleeding using a rigid bronchoscope under general anesthesia. Conclusion. In this report, we propose that TAE before interventional bronchoscopy could be a treatment option to avoid massive bleeding.