Right carinal pneumonectomy for a delayed diagnosis

The authors present the case of a male patient misdiagnosed with right upper lobe tuberculosis and repeatedly treated for this in the last two years, without response. In our institution, the source of the hemoptysis proved to be a pulmonary carcinoma, which in its evolution involved the carina and the last tracheal ring. Right carenal pneumonectomy with two tracheal ring resection is performed, with reconstruction of the airway by anastomosing the main left bronchus to trachea. The resection involved also the azygos vein and the lateral wall of the superior vena cava (angioplastic resection), the vagus nerve and the pericardium, the last are being reconstructed with synthetic mesh. Histopatologic diagnosis is squamous cell carcinoma moderately differentiated. The right tracheal sleeve pneumonectomy was the therapeutically choice for a middle-aged patient with recurrent hemoptysis and retrostenotic lung destruction.