Interventional tracheoscopy for management of intratracheal plasmacytoma in a dog

Abstract

Abstract Intraoperative haemorrhage during interventional tracheoscopy for intratracheal masses can pose a life-threatening challenge. This report emphasizes the technical management of severe bleeding during endoscopic excision of a rare tracheal plasmacytoma in a dog, highlighting the importance of immediate replacement of the endoscope with a larger-calibre device and use of bipolar electrosurgical forceps placed parallel to the endoscope. An 8-year-old male Standard Poodle presented with a two-month history of nonproductive cough and exertional dyspnea. Cervical radiography revealed a nodular mass (1.21 × 1.13 cm) attached to the dorsal wall of the cervical trachea. During anesthetic induction for diagnostic and therapeutic tracheoscopy, the endotracheal tube inadvertently compressed the mass, causing substantial haemorrhage with imminent risk of blood aspiration and airway obstruction. The endoscope was immediately replaced with a larger-calibre (5.9 mm) device to improve lavage and suction. After removing the endotracheal tube to permit parallel instrument placement, initial attempted resection using a polypectomy snare failed due to recurrent bleeding. Bipolar electrosurgical forceps were then introduced parallel to the endoscope, directly grasping and coagulating the tumour base, which achieved hemostasis and enabled gross endoscopic excision (macroscopic removal of the visible tumour). The dog recovered without respiratory distress and was discharged the same day. Histopathology and immunohistochemistry confirmed extramedullary plasmacytoma. Gross endoscopic excision was achieved; histological margins were not assessable due to cautery artefact. The dog remained free of respiratory signs and tumour recurrence at 12-month follow-up.