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Bronchocutaneous fistula from metastatic cervical cancer with COVID-19
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  1. Ross Harrison and
  2. Pedro T Ramirez
  1. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Ross Harrison, Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; rfharrison{at}mdanderson.org

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Description

A 38-year-old woman with a history of stage IVA squamous cell cancer of the cervix presented with pain and an enlarging wound in her central chest. Approximately 20 months earlier the patient developed a cavitary right lung mass that invaded the anterior chest wall. A biopsy of the mass showed squamous cell carcinoma. Despite treatment with radiation and chemotherapy, the mass grew, developing into an open wound. On chest computed tomography, a cavitary mass in the right middle lobe of the lung was found invading through the anterior chest wall (Figure 1). A branch of the right bronchial tree opened into the tumor cavity which also opened anteriorly through the defect in her chest wall (Figure 2). The patient was admitted for pain control. Asymptomatic screening at hospital admission using polymerase chain reaction detected evidence of COVID-19. She was discharged to home hospice.

Figure 1

Representative image from computed chest scan with arrows highlighting communication between the secondary bronchus, pleural space, and external environment.

Figure 2

Clinical appearance of chest wound.

Footnotes

  • Twitter @rossfh, @pedroramirezMD

  • Collaborators Not applicable.

  • Contributors Both authors contributed to the design of the submitted work, participated in critical revision, and approve of the version under submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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