Topical Mitomycin-C for Obstructing Endobronchial Granuloma

An elderly woman with post-tuberculous stricture of the lower trachea and main bronchi underwent laser re-canalization, balloon dilation, and silicone stent insertion in the lower trachea and main bronchi. Subsequently she had recurrent dyspnea develop due to obstructing granulomas, which necessitated four endoscopic procedures in 2 years. The tracheal stent was removed and topical mitomycin-C was applied using saturated pledgets at a dose of 0.5 mg/mL for 2 minutes each over the lower trachea and both orifices of the main bronchi. Follow-up for 24 months showed no recurrence of symptoms. Bronchoscopy and spirometry performed at 2, 6, and 12 months showed resolution of the granulomas.