# Incidental Detection of Tracheobronchopathia Osteochondroplastica During a Bronchoscopy in a Patient With Papillary Thyroid Cancer: A Case Report

## TL;DR

A rare benign condition called tracheobronchopathia osteochondroplastica was found during a routine procedure in a thyroid cancer patient, suggesting a possible link to chronic infection.

## Contribution

This case report presents a rare incidental detection of TPO in a patient with papillary thyroid cancer and suggests a possible infection-driven pathogenesis.

## Key findings

- TPO was incidentally detected during bronchoscopy for hemithyroidectomy in a 45-year-old male.
- Chronic infection, indicated by S. pneumoniae and MRSA in bronchoalveolar lavage, may contribute to TPO development.
- The patient required no specific treatment for TPO and was managed conservatively with antibiotics.

## Abstract

Tracheobronchopathia osteochondroplastica (TPO) is a rare, benign condition characterized by submucosal osseocartilaginous nodules sparing the posterior tracheal wall. We report a unique case of a 45-year-old male with a history of smoking, gastroesophageal reflux disease (GERD), and papillary thyroid carcinoma, in whom TPO was incidentally discovered during intraoperative bronchoscopy for hemithyroidectomy. The patient was asymptomatic from a respiratory standpoint, but bronchoalveolar lavage identified Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA), suggesting a possible role of chronic infection in TPO pathogenesis. Diagnosis was confirmed through imaging and histopathology, revealing typical tracheal nodularity with no airway obstruction. No specific treatment was required for TPO, and the patient was managed conservatively with antibiotics for airway colonization. This case highlights the importance of recognizing TPO during unrelated procedures to avoid misdiagnosis and supports the hypothesis of infection-driven chronic inflammation contributing to its development.