Carinal Squamous Cell Carcinoma Causing Progressive Central Airway Obstruction: CT, FDG PET/CT, Bronchoscopic Pre‐ and Post‐Debulking, and Pathologic Correlation

Saubhagya Dhakal; Govinda Adhikari; Ali Kanj Ahmad

doi:10.1155/crra/3075194

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Carinal Squamous Cell Carcinoma Causing Progressive Central Airway Obstruction: CT, FDG PET/CT, Bronchoscopic Pre‐ and Post‐Debulking, and Pathologic Correlation

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Carinal Squamous Cell Carcinoma Causing Progressive Central Airway Obstruction: CT, FDG PET/CT, Bronchoscopic Pre‐ and Post‐Debulking, and Pathologic Correlation

Saubhagya Dhakal, Govinda Adhikari and Ali Kanj Ahmad

Case reports in radiology, Vol.2026(1), 3075194

08/05/2026

DOI: 10.1155/crra/3075194

PMID: 42564445

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Abstract

Primary tracheobronchial tumors are rare and are frequently diagnosed late because their presenting symptoms are nonspecific and may mimic more common respiratory conditions. We report a case of a 74‐year‐old man with a significant smoking history who presented with progressive dyspnea, cough, hemoptysis, and stridor, initially treated with multiple courses of antibiotics and corticosteroids, without improvement. Chest radiography was reportedly normal, but a contrast‐enhanced CT demonstrated an endoluminal soft tissue mass centered at the distal trachea/carina with extension into the bilateral mainstem bronchi, causing near‐complete obstruction of the left mainstem bronchus and moderate‐to‐severe narrowing of the right mainstem bronchus. Coronal FDG PET/CT demonstrated intense metabolic activity centered at the carina. Predebulking bronchoscopy confirmed a verrucous fungating carinal mass causing severe central airway compromise, whereas postdebulking bronchoscopy showed marked restoration of airway patency. Histopathologic evaluation established squamous cell carcinoma. This case highlights the diagnostic limitations of chest radiography and the essential role of CT, FDG PET/CT, and bronchoscopy in evaluating malignant central airway obstruction.

Computed Tomography

Case Report

bronchoscopy

carina

central airway obstruction

FDG PET/CT

squamous cell carcinoma

tracheal tumor

UIOWA OA Agreement

Details

Title: Subtitle: Carinal Squamous Cell Carcinoma Causing Progressive Central Airway Obstruction: CT, FDG PET/CT, Bronchoscopic Pre‐ and Post‐Debulking, and Pathologic Correlation
Creators: Saubhagya Dhakal - University of Iowa
Govinda Adhikari - University of Iowa
Ali Kanj Ahmad - University of Iowa
Resource Type: Journal article
Publication Details: Case reports in radiology, Vol.2026(1), 3075194
DOI: 10.1155/crra/3075194
PMID: 42564445
ISSN: 2090-6862
eISSN: 2090-6870
Publisher: Wiley
Language: English
Date published: 08/05/2026
Academic Unit: Radiology
Record Identifier: 9985217636002771

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