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Malignant central airway obstruction — SCE Respiratory MCQ

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HardInterventional PulmonologyMalignant central airway obstructionSCE Respiratory

A 70-year-old man with known squamous cell lung cancer develops stridor and severe dyspnoea. CT shows tumour causing critical distal tracheal narrowing. He is not fit for surgery and has received steroids and nebulised adrenaline while awaiting definitive treatment. What is the most appropriate management?

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Correct answer: B — Urgent therapeutic bronchoscopy with airway debulking or stenting

Critical malignant central airway obstruction with stridor requires urgent interventional bronchoscopy to restore airway patency where feasible. Spirometry is unsafe and unhelpful in critical obstruction. Antibiotics, sleep study and pleural aspiration do not relieve tracheal narrowing.

Reference: NICE NG122 Lung Cancer; BTS Interventional Bronchoscopy Guidance