Tracheal Rhinosporidiosis: A Report of a Rare Case From Odisha, India.

We report a very rare case of tracheal rhinosporidiosis having multiple sites of involvement in the tracheal lumen, almost completely obstructing the lumen near the carina, which was removed by using peripheral cardiopulmonary bypass (CPB) with a multidisciplinary team approach involving the ENT and cardiothoracic vascular surgery (CTVS) departments. Since the location of the mass was in the lower trachea and there was a higher risk of bleeding, CPB was done. An open approach was considered for the surgery. A U-shaped neck incision was given, and the trachea was opened at the level of the third, fourth, and fifth tracheal rings. A Hopkins 0° 3 mm 14 cm endoscope was used to visualize the mass, which almost occupied the whole lumen of the trachea near the carina. A rhinosporidiosis mass was found to be attached to the anterolateral aspect of the trachea. The stump of the mass was cauterized by bipolar suction cautery and coblator, and the mass was delivered. The trachea was closed with a cuffed tracheostomy tube (7.5 mm inner diameter (ID)) in situ. After confirming satisfactory ventilation, the patient was weaned off CPB. The duration of CBP was 120 minutes, and the duration of surgery was 80 minutes. The patient was kept in the ICU for 24 hours after surgery. The tracheostomy tube was removed on the fifth post-op day. The patient had an uneventful recovery. The histopathological study of the resected specimen showed sporangia filled with small, round endospores of . We report a rare case of rhinosporidiosis that had to be managed in an unconventional method due to the site and size of the pathology, and to minimize the risk to the patient.