Abstract Introduction Mounier-Kuhn syndrome (MKS) is a rare disorder of tracheobronchomegaly resulting from loss of elastic and smooth muscle components of the central airways, leading to dilation of the trachea and main bronchi, impaired mucociliary clearance and frequent secondary airway complications (bronchiectasis, recurrent infection). Case report A 63-year-old male with a 40 pack-year smoking history presented in the office three years ago for chronic cough; chest CT at that time revealed an ovoid pleural mass and tracheobronchomegaly consistent with presumptive MKS (no prior imaging for comparison). He was lost to follow-up and then re-established care in October 2025. A lung-screening CT now demonstrates persistently enlarged trachea and bronchi (stable tracheobronchomegaly) but worsened bronchiectatic changes and a new spiculated right lung base mass measuring 46.5 × 20.2 mm. The combination of longstanding airway dilation, smoking history and new lung mass raises the concern for lung carcinoma in the context of MKS and secondary bronchiectasis. Discussion In patients with MKS, structural airway abnormalities predispose to mucus stasis, recurrent infection and bronchiectasis; bronchiectasis itself is associated with increased risk of malignancy. Although formal epidemiologic data are limited for lung cancer risk specifically in MKS, the combination of tracheobronchomegaly, smoking, bronchiectasis and a new spiculated lesion warrants prompt investigation. Early recognition of MKS is important as it influences surveillance for secondary complications (bronchiectasis progression, infection, and potentially malignancy). This case illustrates the need for vigilance in follow-up of MKS patients—especially those with significant smoking history—and highlights the gap in literature regarding lung cancer risk in this population. References: • Ayub F, Saif MW, et al. First case report of metastatic squamous cell carcinoma of lung associated with Mounier-Kuhn syndrome. Cureus (2017). PMCKrustins E., et al. Mounier-Kuhn syndrome: review. Respiratory/clinical review (2013). resmedjournal.comWang Y., et al. Mounier-Kuhn syndrome: a tripartite analysis bridging clinical, radiological and histopathological findings. Orphanet J Rare Dis (2025). This abstract is funded by: None
Jamil et al. (Fri,) studied this question.