Large Carinal Chondrosarcoma: Resection of the Main Carina, Distal Trachea, and Orifices of the Mainstem Bronchi and Construction of a New Carina.
Dimitrios I Viskos, Ioannis P Pantazis, Fotios F Danglis et al.
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Case in brief
A 23-year-old man presented with dyspnea, fatigue, and cough. CT showed a lobulated mass anterior to the distal trachea and main carina; bronchoscopy demonstrated carinal widening, significant stenosis of both mainstem bronchi, and mucosal infiltration. Mediastinoscopy biopsy identified well-differentiated chondrosarcoma. The distal trachea, carina, and mainstem bronchial orifices were resected through a right posterolateral thoracotomy, and a new carina was constructed and anastomosed to the distal trachea. He remained well without recurrence 17 years after resection.
What made this case unusual
The tumor involved the main carina, requiring resection of the carina, distal trachea, and mainstem bronchial orifices followed by construction of a new carina.
Diagnostic / clinical pearl
A carinal mass causing mainstem bronchial stenosis may be chondrosarcoma; tissue diagnosis and assessment of the airway extent are important to defining the surgical approach.
Why it matters
This case documents long-term absence of recurrence after complex carinal resection and reconstruction for a well-differentiated chondrosarcoma.