Is interventional bronchoscopy the first-line solution for mediastinal compression syndrome?

The mediastinum is known as the anatomical structure connecting the two pleural sacs. A variety of anatomical structures, from organs to veins and arteries, make mediastinal pathology extremely adventurous. We submit the case of a 67-year-old female patient, a former smoker, who presented to our clinic with dyspnoea on slight exertion, anterior chest pain and ineffective cough. The alarming aspect of the case is the stridor present at regular intervals and the patient’s dependence on oxygen. The CT scan reveals a compression syndrome caused by a tumour located in the upper and middle mediastinum that encompasses mediastinal venous and arterial structures and exerts an extrinsic stress effect on the oesophagus and tracheal. An emergency fibrobronchoscopy is performed and it is placed on a Y-shaped tracheal stent; additionally, two biopsies are also taken from different places. The point of debate of the case was related to the coexistence of two simultaneous histopathological types. The medical team’s swift intervention has given this patient a fighting chance to continue oncological and radiotherapy treatment.