Endobronchial Primitive Neuroectodermal Tumor With Pneumothorax Ex Vacuo

Abstract

We experienced a rare case of an endobronchial primitive neuroectodermal tumor of the left main bronchus. Initially we suspected pneumothorax caused by a collapsed left upper lobe and an air-entrapped lower lobe. After tube thoracostomy, the pneumothorax persisted without air leakage. A tumor was detected at the left main bronchus on computed tomography and bronchoscopy, and diagnosed pathologically as small cell lung cancer. Under the presumed diagnosis of limited-stage small cell lung cancer, we performed a left pneumonectomy. The tumor was eventually identified pathologically as a primitive neuroectodermal tumor. Although adjuvant chemoradiotherapy was not performed, no recurrence was observed.

Primary bronchial Ewing sarcoma

“…Bronchial ES tumors are usually pedunculated, exophytic tumors involving a portion of the bronchial circumference and may be amenable to snare resection through a bronchoscope, however this approach may be associated with a higher risk of local recurrence as these tumors may invade into the underlying submucosa, muscle and cartilage [9]. While tumors in the distal bronchial airway and pulmonary parenchyma may need a lobectomy, tumors in the proximal trachea bronchial airway can be treated safely with sleeve resection when possible as illustrated in our patient.…”