Presentation
15 year old male patient presenting with new onset dyspnea over 1 year with pulmonary function tests demonstrating a restrictive pattern.
Patient Data
Endobronchial mass involving the bifurcation of the left mainstem bronchus which initially went unnoticed by the radiologist who first interpreted this x-ray as normal. Of note, there is no significant atelectasis of the left lung visible, indicating that the mass is not fully obstructive.
Annotated Image Outlining the Endobronchial Mass
Endobronchial mass is outlined.
Chest CT done 2 mth later because of symptom progression
Coronal CT of the chest demonstrates a well-defined partially obstructive endobronchial mass at the bifurcation of the left mainstem bronchus thought to most likely represent an endobronchial carcinoid tumor in this 15 year-old boy.
1 year post-operative x-ray
Case Discussion
This case demonstrates the importance of paying attention to the airways when evaluating every chest x-ray. This young patient presented with worrisome symptoms and an evident endobronchial mass on his first x-ray which was flagged as normal.
The patient went on to have a left lower lobectomy and sleeve procedure with an uneventful recovery.
Pathology confirmed an endobronchial carcinoid tumor which was entirely resected.
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