<i>Metalloptysis</i> : spontaneous expectoration of stent fragments from a disintegrated self-expanding metallic airway Y-stent

The subspecialty of interventional bronchoscopy has grown exponentially in recent times, and airway stenting is a frequently performed procedure. It is a therapeutic bronchoscopic intervention for both benign and malignant conditions, being mostly performed with a palliative intent, especially in cases of malignant central airway obstruction (CAO).We report a previously undocumented complication of airway stenting-disintegration of a self-expanding metallic stent (SEMS) and its spontaneous expectoration. A man in his late 40s with newly diagnosed squamous cell carcinoma of the lung presented with CAO and respiratory failure. Rigid bronchoscopy with tumour debulking and Y-SEMS placement was performed, resulting in clinical stabilisation. Four-and-a-half months post-stenting, the patient presented with expectoration of metallic fragments. Bronchoscopy revealed extensive disintegration of the posterior wall of the tracheal limb of the stent, with the bronchial limbs intact. The disintegrated stent was carefully removed under rigid bronchoscopy without any complications. Given adequate airway patency, no replacement stent was inserted. The patient continued systemic chemotherapy and remained stable, with no recurrence of airway compromise. This case highlights an unusual delayed complication of airway stenting.