Central Airway Recanalisation Using Dual Debulking With Para-Toluenesulfonamide (CLEAR-DUAL-PTS).

Area of Science:

• Pulmonology
• Oncology
• Interventional Pulmonology

Background:

• Pulmonary adenoid cystic carcinoma (PACC) is a rare malignancy of the tracheobronchial tree.
• PACC can lead to severe malignant airway obstruction (SMAO), requiring prompt intervention.
• Surgical resection is standard, but alternatives are needed for inoperable patients or those who decline surgery.

Purpose of the Study:

• To report a case of PACC-SMAO treated with a novel bronchoscopic approach.
• To evaluate the efficacy and safety of dual debulking combined with intratumoral para-toluenesulfonamide (PTS) injections.

Main Methods:

• Bronchoscopic dual debulking using electrocautery snaring.
• Repeated intratumoral para-toluenesulfonamide (PTS) injections.
• Management of a 57-year-old non-smoking female with PACC-SMAO causing left lung collapse.

Main Results:

• Successful tumor burden reduction and restoration of airway patency.
• Significant improvement in clinical and radiological outcomes.
• No adverse events reported during the intervention.

Conclusions:

• Para-toluenesulfonamide (PTS) shows promise as an adjunct therapy for inoperable PACC-SMAO.
• This bronchoscopic approach may offer a viable alternative to surgery.
• Further research is needed to determine long-term efficacy and optimal dosing of PTS.