Endobronchial/Tracheal Metastasis and Sudden Death

Byard, Roger W.

doi:10.1111/1556-4029.12431

Cited by 12 publications

(7 citation statements)

References 38 publications

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“…15 Intraluminal metastases occluding the airway may also arise from distant sites such as primary renalcell carcinomas. 16 In the second case, the oesophageal tumour had infiltrated through the aortic wall into intimal atherosclerotic plaque, resulting in fistula formation. Most cases of aorto-oesophageal fistulas are due to atherosclerotic aortic aneuryms, 17,18 although tumours of the oesophagus are known to erode into vessels, which in addition to the aorta may include the carotid, subclavian, oesophageal and intercostal arteries.…”

Section: Discussionmentioning

confidence: 99%

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Causes of sudden death related to oesophageal carcinoma

Byard

2020

Med Sci Law

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Two cases of recently diagnosed oesophageal squamous-cell carcinomas in men, both aged 72 years, are reported that resulted in rapid clinical deterioration and death from upper-airway occlusion and haemorrhage, respectively. In the first case, direct growth of the tumour from metastatic deposits in the paratracheal lymph nodes through the wall of the trachea resulted in lethal acute airway occlusion. In the second case, local extension of the tumour through the wall of the oesophagus into the adjacent aorta resulted in an aorto-oesophageal fistula which led to catastrophic and fatal haemorrhage. Although rare, oesophageal squamous-cell carcinomas may cause unexpected death due to quite different mechanisms, and result in the need for a detailed medico-legal assessment.

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Section: Discussionmentioning

confidence: 99%

“…15 Intraluminal metastases occluding the airway may also arise from distant sites such as primary renal-cell carcinomas. 16…”

Section: Discussionmentioning

confidence: 99%

Causes of sudden death related to oesophageal carcinoma

Byard

2020

Med Sci Law

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“…Endobronchial tumour embolism resulting in complete obstruction of the contralateral mainstem bronchus (MSB) is a rare and often fatal event . Byard recently recommended that the phrase “tumor fragmentation with airway impaction” replace endobronchial tumour embolism as the term embolism refers specifically to obstruction within the blood stream and not the airway. However, the majority of published cases in the literature use the latter term.…”

Section: Discussionmentioning

confidence: 99%

It's better to be lucky … successful management of an acute endobronchial tumour embolism in the ICU: a case report and review of the literature

Walsh

Olivenstein

Forget³

et al. 2017

Respirology Case Reports

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Endobronchial tumour embolism is a rare cause of acute central airway obstruction. It is primarily reported during pneumonectomy, and the outcome is frequently fatal. Successful management requires the urgent removal of tumour with rigid or flexible bronchoscopy. We present the case of a 62‐year‐old woman with poorly differentiated non‐small cell lung cancer (NSCLC), referred to our institution for Nd:YAG laser photoresection of endobronchial tumour completely obstructing the right mainstem bronchus (RMSB). Soon after admission, our patient developed critical hypoxemia, rapidly followed by cardiac arrest. Bronchoscopy was urgently performed and revealed a necrotic tumour occluding the left mainstem bronchus (LMSB), with some residual tumour and clot at the RMSB. The tumour acutely obstructing the LMSB was successfully extracted using a foreign body retrieval basket and large flexible biopsy forceps via a large (therapeutic) flexible bronchoscope. Ventilation immediately improved, with the return of a pulse, and the patient was successfully extubated the next day. Pathology of the tumour embolism revealed NSCLC with necrosis and an adherent clot. Here, we review 16 published reports of endobronchial tumour embolism in relation to our case.

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“…Natural disease that may cause sudden and lethal airway narrowing includes anaphylactic reactions with critical swelling of the epiglottis and benign or malignant tumors (the latter including primary and secondary lesions) that cause obstruction by either growth within the lumen of the airway or external compression . Airway narrowing may also be exacerbated by the effects of narcotic analgesics, hemorrhage, or an unusual position of the neck and head .…”

Section: Discussionmentioning

confidence: 99%

Lethal Laryngopyocele

Byard

Gilbert

2014

Journal of Forensic Sciences

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A 44-year-old man collapsed after complaining of difficulty breathing. Layer dissection of the neck at autopsy revealed a large mixed internal and external laryngopyocele occluding the upper airway. It contained 30 mls of yellow-gray pus. Mechanisms of death in laryngoceles involve obstruction of the opening into the larynx resulting in accumulation of mucus or air within the sac causing airway occlusion. Once infection supervenes, deaths in laryngopyocoeles result either from accumulated pus causing airway occlusion from a mass effect (as in the current case) or the discharge of pus into the airway causing death from aspiration. Sudden death in laryngopyoceles is a very rare event that requires careful dissection at autopsy to demonstrate the characteristics of the underlying lesion and the possible mechanism of death. Laryngopyocele should be considered in the differential diagnosis of natural conditions causing acute, potentially lethal, upper airway obstruction.

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Endobronchial/Tracheal Metastasis and Sudden Death

Cited by 12 publications

References 38 publications

Causes of sudden death related to oesophageal carcinoma

Causes of sudden death related to oesophageal carcinoma

It's better to be lucky … successful management of an acute endobronchial tumour embolism in the ICU: a case report and review of the literature

Lethal Laryngopyocele

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