Anaesthetic management of a bleeding intratracheal mass

Abstract

A long-standing thyroid mass can have varied presentation depending on the metabolic, compressive or invasive symptoms. The most apparent symptom of thyroid mass is goitre, which if ignored can prove to be catastrophic as in our case. It is uncommon for thyroid mass to present as airway bleeding. However, a patient with long standing goitre presented with frank hemoptysis to our hospital. Radiological study revealed a thyroid mass, infiltrating the tracheal wall and extending into the tracheal lumen. A bleeding intratracheal mass presents a multifactorial challenge to an anaesthetist. Authors present anaesthetic management of a case of infiltrating thyroid malignancy presenting as a bleeding intratracheal mass. The haemostasis and airway patency were restored until definitive surgery was planned. The need for tracheostomy could be avoided in this case. A meticulously planned airway management along with multi-disciplinary approach are important for management of bleeding intratracheal mass.