ABSTRACT

Tracheobronchopathia osteochondroplastica is a rare condition, with an incidence rate between 0.25 and 0.3% in autopsy studies and approximately 0.01 to 0.8% in bronchoscopic findings. In our setting, we do not have specific statistics due to its rare presentation and diagnosis. Its etiology is still not well established, although it has been associated with immunoglobulin A deficiency and bone morphogenetic protein 2, as well as possible infections by bacteria or mycobacteria. Clinically, it is characterized by the appearance of osteocartilaginous nodular lesions in the submucosa of the central airways, which may protrude into the tracheal or bronchial lumen, generally causing nonspecific symptoms such as cough, hemoptysis, dyspnea, wheezing, and recurrent respiratory infections, and, as in the case of our patient, ventilatory failure. We present the case report of a patient who was admitted to our institution with a history of cough and dyspnea, leading to ventilatory failure, initially requiring non-invasive mechanical ventilation (NIMV). Further studies revealed the presence of calcified lesions and nodules in the upper airway on chest tomography. These lesions were confirmed by bronchoscopy, showing osteocartilaginous characteristics. The pathological report of the biopsy of these lesions was consistent with tracheobronchopathia osteochondroplastica. The patient was treated with antibiotic coverage and pneumatic dilations of the obstructive lesions in the upper airway. Subsequently, the patient showed adequate clinical improvement, resolving the ventilatory failure and being discharged without the need for supplemental oxygen or additional support.

KEYWORDS

tracheobronchopathia osteochondroplastica, airway obstruction, tracheal stenosis, benign tracheal dysplasia.

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