0
Abstract: Case Reports |

PHOTODYNAMIC THERAPY (PDT) FOR GRANULATION TISSUE DESTRUCTION 10 YEARS AFTER STENT PLACEMENT FREE TO VIEW

Gabor T. Varju, MD*; Cynthia D. Brown, MD; Ron Allison, MD; Rosa Cuenca, MD; Claudio Sibata, PhD; Jon Moran, MD; Gordon Downie, MD
Author and Funding Information

East Carolina University, Pitt County Memorial Hospital, Greenville, NC


Chest


Chest. 2005;128(4_MeetingAbstracts):409S. doi:10.1378/chest.128.4_MeetingAbstracts.409S
Text Size: A A A
Published online

Abstract

INTRODUCTION:  Airway stent placement for palliation of malignant airway obstruction symptoms is an accepted intervention in the care of lung cancer patients. A common complication of stent placement is granulation tissue reaction that can occlude stents. Removal of stents for this indication can require rigid bronchoscopy and hours of manipulation with ablative technologies. PDT is currently used as part of multimodality therapy for airway management in lung cancer.

CASE PRESENTATION:  A 68 year old African-American female limited stage small cell lung cancer survivor received a left main stem wall-stent followed by chemotherapy and radiation in 1995. She presented nine years later with hemoptysis and 3 years of progressive dyspnea on exertion. Bronchoscopy revealed 90% stenosis over 4 cm in the left main bronchus with granulation tissue overgrowth. A chest CT scan demonstrated volume loss in the left lung. Biopsy showed no recurrence of malignancy. The stenosis was treated with PDT with a complete tissue response; follow-up CT scan demonstrated increased volume. Mitomycin C at the stent site was applied to prevent recurrence of granulation tissue.

DISCUSSIONS:  Nonsurgical lung cancer patients appear to be surviving longer in selected cases. Some are experiencing local complications of their aggressive therapies. Symptoms from granulation tissue airway obstruction can limit the quality of life of these patients. In our case PDT was used to evoke destruction with excellent clinical response and no complications. PDT provided an extensive rapid elimination of granulation tissue as an outpatient using a flexible bronchoscope. Mitomycin C prevented recurrent granulation tissue formation at 6 months follow up.

CONCLUSION:  PDT followed by mitomycin is a reasonable alternative to restore and maintain airway patency in this clinical setting of nonmalignant hypervascularized endobronchial overgrowth.

DISCLOSURE:  Gabor Varju, None.

4:15 PM - 5:45 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543