title: A complication of tracheobronchopathia osteochondroplastica presenting as acute hypercapnic respiratory failure.
abstract: BACKGROUND
  Tracheobronchopathia osteochondroplastica is a rare benign and often indolent disease. We report the first case of tracheobronchopathia osteochondroplastica (TBO) presenting as acute hypercarbic respiratory failure due to superimposed subglottic submucosal abscess.
  
  
  METHODS
  A 27-year-old man presented to the emergency department in respiratory distress that required mechanical ventilation for acute hypercarbic respiratory failure. Upon extubation the next day, stridor was elicited with ambulation. Spirometry revealed fixed upper airway obstruction. Neck imaging showed a 2.8 × 2.0 × 4.0 cm partially calcified subglottic mass with cystic and solid component obstructing 75% of the airway. Surgical exploration revealed purulent drainage upon elevation of the thyroid isthmus and an anterolateral cricoid wall defect in communication with a subglottic submucosal cavity. Microbiology was negative for bacteria or fungi. Pathology showed chondro-osseous metaplasia compatible with tracheobronchopathia osteochondroplastica (TBO). The patient received a course of antibiotics and prophylactic tracheostomy. Since tracheostomy removal 3 days later, the patient remains asymptomatic.
  
  
  CONCLUSIONS
  Tracheobronchopathia osteochondroplastica is a rare disease with usually benign clinical course and incidental diagnosis. It may present as acute hypercarbic respiratory failure when subglottic infection is superimposed.
authors: Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Medical Center, New York, NY, USA.
authors: Mauricio
authors: M
authors: Danckers
authors: Department of Radiology, New York University Langone Medical Center, New York, NY, USA.
authors: Roy A
authors: RA
authors: Raad
authors: Department of Pathology, New York University Langone Medical Center, New York, NY, USA.
authors: Ronaldo
authors: R
authors: Zamuco
authors: Division of Otolaryngology, New York University Langone Medical Center, New York, NY, USA.
authors: Aron
authors: A
authors: Pollack
authors: Division of Otolaryngology, New York University Langone Medical Center, New York, NY, USA.
authors: Scott
authors: S
authors: Rickert
authors: Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Medical Center, New York, NY, USA.
authors: Caralee
authors: C
authors: Caplan-Shaw
mesh_terms: D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D006935:Hypercapnia / Q000175:diagnosis / Q000209:etiology*; D007828:Laryngoscopy; D008297:Male; D010009:Osteochondrodysplasias / Q000150:complications / Q000175:diagnosis*; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014133:Tracheal Diseases / Q000150:complications / Q000175:diagnosis*
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