What happened, in summary

A 31-year-old woman who had never smoked developed increasing shortness of breath, dry cough, and occasional wheezing beginning in June 2014. In May 2016, worsening symptoms and a chest X-ray suggested left-sided pneumonia. Antibiotics helped temporarily, but the imaging changes did not fully clear. CT then showed an endobronchial mass obstructing the left lower-lobe bronchus, with lung collapse and consolidation behind it.

Interventional bronchoscopy was first used to debulk the tumor and reopen the airway. The initial endoscopic biopsy suggested low-grade mucoepidermoid carcinoma, but the final surgical specimen showed that the tumor was high grade. She then underwent complete surgical resection.

Because the tumor had been partly reduced before surgery, the multidisciplinary team proposed Stage IB disease, T2aN0M0, based on its original size and the associated lung collapse. Based on the high-grade pathology, proposed stage, and her young age, the team planned adjuvant carboplatin and vinorelbine.