Tracheostomy and venovenous extracorporeal membrane oxygenation for difficult airway patient with carinal melanoma: A case report and literature review

Figure 1 Preoperative chest computed tomography images of patient. A: Axial view; B: Coronal view. These computed tomography images show a large tracheal protruding mass (orange arrow) at the carinal level, approximately 3.0 cm in size, causing nearly total obstruction of the left main bronchus and left lung hyperinflation.

Figure 2 Preoperative flexible bronchoscopy images of patient. A: Carinal level; B: Left main bronchus; C: Right main bronchus. These bronchoscopy images show a large, black-pigmented, protruding mass is evident at the carinal level (A), causing near-total occlusion of the left main bronchus (B) and partial occlusion of the right main bronchus (C).

Figure 3 Chest radiography and computed tomography images obtained during previous episodes of general anesthesia. A-C: Right temporal craniotomy performed at age 40 (October 2019); D-F: oral commissure reposition surgery performed at age 41 (February 2020). These images reveal gradual left lung hyperinflation (A and D), and progressively enlarged carinal masses, approximately 1.2 cm and 2.1 cm in size, respectively. (axial view in B and E; coronal view in C; and sagittal view in F).