[Is it difficult-to-treat asthma? Or another diagnosis?]

When suspected of difficult-to-treat asthma, it is important to detect causal factors. Central airway malignancy should also be excluded in this group.

We describe the case of a 23-year-old woman who came to the emergency room for shortness of breath and was subsequently admitted to the intensive care unit for respiratory failure, indicated by an asthma exacerbation. At an outpatient visit for dyspnea complaints, now with a stridor on physical examination, a chest CT was performed, which showed an occlusive lesion. Bronchoscopy turned out to be an endobronchial tumor. PA showed that it was a primary pulmonary myxoid sarcoma.

The case above shows why it is important to consider rare pathologies, such as a central airway tumor, in asthma that is difficult to treat. A thorough history and physical examination is an important first step, especially the presence of a stridor.