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CASE REPORT
Submucosal Injection of Mitomycin C in a Case of Vanishing Bronchus After Lung Transplant

Segmental nonanastomotic stenosis, also known as vanishing bronchus intermedius syndrome (or simply, “vanishing bronchus”), is a rare complication that can occur after a lung transplant. It usually occurs in the first posttransplant year and often develops in the intermediate bronchus. Definitive diagnosis is established by bronchoscopy. The treatment management primarily includes bronchoscopic dilatation and stenting. In patients who do not benefit from these applications, lung resection or retransplant may be indicated. Our 58-year-old patient developed vanishing bronchus after lung transplant, and recurrence could not be prevented despite repeated bronchoscopic interventions. We applied submucosal mitomycin C injection to the bronchial wall of the stenotic segment and achieved significant benefit for reduction of recurrence. Our aim was to document the first reported case of a patient with vanishing bronchus who was treated with submucosal administration of mitomycin C, a strong fibroblast inhibitor, and to report the outcomes of submucosal mitomycin C administration with regard to recurrence.


Key words : Airway management, Bronchial stenosis, Vanishing bronchus intermedius syndrome

Segmental nonanastomotic stenosis, also known as vanishing bronchus intermedius syndrome (or simply, “vanishing bronchus”), is a rare complication that can occur after a lung transplant. It usually occurs in the first posttransplant year and often develops in the intermediate bronchus. Definitive diagnosis is established by bronchoscopy. The treatment management primarily includes bronchoscopic dilatation and stenting. In patients who do not benefit from these applications, lung resection or retransplant may be indicated. Our 58-year-old patient developed vanishing bronchus after lung transplant, and recurrence could not be prevented despite repeated bronchoscopic interventions. We applied submucosal mitomycin C injection to the bronchial wall of the stenotic segment and achieved significant benefit for reduction of recurrence. Our aim was to document the first reported case of a patient with vanishing bronchus who was treated with submucosal administration of mitomycin C, a strong fibroblast inhibitor, and to report the outcomes of submucosal mitomycin C administration with regard to recurrence.


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DOI : 10.6002/ect.2020.0203


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From the Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
Acknowledgements:The authors have not received any funding or grants in support of the presented research or for the preparation of this work and have no declarations of potential interest. All authors contributed equally to this case report.
Corresponding author: Muhammet Ali Beyoglu, MH2 binasi, B1 kati, E2 bolumu, Universiteler Mahallesi 1604, Cadde No. 9 Çankaya, Ankara, Turkey
E-mail: muhammetalibeyoglu@gmail.com