Tracheal stenosis: an unusual presenting complication of idiopathic fibrosing mediastinitis

Idiopathic fibrosing mediastinitis is a rare, obliterative, inflammatory process which is characterized by an abnormally exuberant proliferation of fibrous tissue within the superior mediastinum, resulting in the encroachment and occlusion of its contained structures. Usually, this is one of the low-pressure vascular structures, most often the superior vena cava. Airway obstruction as a primary presenting complication of this condition is rare with past treatment results usually being palliative at best. In this article, a patient with this complication is presented in whom emergent surgical treatment and tracheal decortication afforded permanent relief. The clinial presentation, morphology of the disease, and treatment are reviewed.