Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.
Adenoma, Pleomorphic ; Asthma ; Bronchi ; Cough ; Diagnosis ; Dyspnea ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; Recurrence ; Salivary Glands ; Thorax ; Trachea ; Tracheal Neoplasms ; Tuberculoma ; Tuberculosis, Pulmonary

Adenoma, Pleomorphic ; diagnosis ; pathology ; Humans ; Trachea ; pathology ; Tracheal Neoplasms ; diagnosis ; pathology

Asthma ; diagnosis ; Bronchial Neoplasms ; diagnosis ; Child ; Diagnosis, Differential ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic ; diagnosis ; Tracheal Neoplasms ; diagnosis

Primary tracheal tumours are rare and less frequently observed than bronchial tumours. Primary neurogenic tumours of the trachea as schwannomas or neurilemmomas are extremely uncommon. We report a tracheal schwannoma in a female patient who presented with breathlessness and wheeze, and she was being treated for asthma. Flexible bronchoscopy revealed a large pedunculated tracheal mass and biopsy confirmed schwannoma. She was treated with laser ablation with partial reduction of the tumour. Subsequently, she was lost to follow-up, although resection of the tumour with tracheal reconstruction was planned.
Adult ; Asthma ; diagnosis ; Biopsy ; Bronchoscopy ; Diagnosis, Differential ; Diagnostic Errors ; Dyspnea ; diagnosis ; etiology ; Female ; Follow-Up Studies ; Humans ; Neurilemmoma ; diagnosis ; surgery ; Radiography, Thoracic ; Reconstructive Surgical Procedures ; Respiratory Sounds ; diagnosis ; etiology ; Tomography, X-Ray Computed ; Trachea ; diagnostic imaging ; pathology ; surgery ; Tracheal Neoplasms ; diagnosis ; surgery

Primary tracheal tumors are relatively rare. Here we report one case of primary adenoid cystic carcinoma of the trachea which was ever misdiagnosed as asthma and hysteria. In this case, the pulmonary function test was normal, and firstly no obvious abnormalities were found in laryngoscopy, bronchoscopy and CT scan of chest. Later a sagittal and coronal reconstruction CT scan of trachea showed a mass situated in the subglottic trachea. Lastly a laryngoscopy was again done after a tracheal incision and showed a small mass in the posterior wall of the subglottic trachea, and tumor ablation was performed. In addition, we reviewed the literature of primary tracheal tumors and summarized the epidemiology, presenting features, available therapeutic options of the disease.
Carcinoma, Adenoid Cystic ; diagnosis ; Female ; Humans ; Middle Aged ; Tracheal Neoplasms ; diagnosis

INTRODUCTIONTracheobronchial tumours usually cause an airway obstruction and secondary pulmonary infections. Although rare, they are an important differential diagnosis as they may mimic other conditions and diseases. This paper aims to analyse clinical, radiological and histological characteristics of the patients with tracheobronchial tumours diagnosed for a period of 7 years.

MATERIALS AND METHODSIn this retrospective, observational study, we carefully reviewed 65 patients who were diagnosed with tracheal and endobronchial tumours, and performed statistical analysis on the results.

RESULTSAmong these 65 patients (36 men and 29 women) with a mean age of 48.8 years (range, 15 to 75), 50 had malignant tumours while 15 had benign ones. The most common symptoms were cough, chest pain and haemoptysis. Cough was a more frequent symptom in patients with benign tumours (P <0.0014). Only 2 patients were asymptomatic. Tumours were predominantly localised in the large airways (46 in large bronchi and 2 in trachea). The most common radiological manifestation of malignant tumours was tumour mass (46%) followed by atelectasis. One third benign tumour caused atelectasis, while tumour mass and consolidation were found in 3 patients each. Computerised tomography revealed endoluminal tumour mass in 29.2% of the cases, which was more frequently found in benign than malignant tumours (47% vs 24%, respectively). On bronchoscopy, tumours were visible in 73% and 70% benign and malignant cases respectively.

CONCLUSIONTracheobronchial tumours should be ruled as a possible diagnosis in patients with cough, haemoptysis, dyspnoea and chest pain. The imaging techniques and histological examination of the tissue would subsequently lead to correct diagnosis and proper treatment can be administered.

Adolescent ; Adult ; Aged ; Airway Obstruction ; diagnosis ; Bronchial Neoplasms ; complications ; diagnosis ; diagnostic imaging ; Bronchoscopy ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Atelectasis ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tracheal Neoplasms ; complications ; diagnosis ; diagnostic imaging

OBJECTIVEPrimary airway neoplasms are extremely rare in the pediatric age group. This paper reports 4 children with primary airway neoplasms to explore the clinical manifestations, safety and efficacy of bronchoscopic interventions.

METHODThe data of pathology, photographic documentation and imaging studies were analyzed.

RESULTOf the 4 reported lesions, 2 were characterized by low-grade (2 with mucoepidermoid carcinoma) and 2 by high grade malignant (spindle cell carcinoma and malignant lymphoma). Onset of clinical manifestations occurred at the ages of 7 months to 7 years. All of them were initially misdiagnosed as bronchitis, asthma or atelectasis. The lesions located in trachea in 2 patients, in left bronchus of 1 patient and in right middle bronchus of 1 case. Atelectases occurred in bilateral bronchus where the lesions obstructed almost the entire lumen at the time of diagnosis. The diagnosis of airway masses depends upon maintaining a high index of suspicion, complemented by imaging and timely diagnostic endoscopy. The lesions were completely removed in 3/4 patients except 1 died during bronchoscopic procedures.

CONCLUSIONThe children with malignant airway neoplasms were presented with cough and wheezing without specific manifestations. Bronchoscopic interventions were effective in the treatment of non-operative cases. General anesthesia is strongly recommended for interventional bronchoscopy.

Bronchoscopy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Retrospective Studies ; Tracheal Neoplasms ; diagnosis ; therapy

Aged ; Chondroma ; diagnosis ; Diagnostic Errors ; Humans ; Laryngeal Neoplasms ; diagnosis ; Male ; Tracheal Neoplasms ; diagnosis

OBJECTIVETo summarize the experience in diagnosis and treatment of primary tracheal tumors, and to improve the life quality of patients.

METHODSSixty-three patients with primary tracheal tumors treated in the First Affiliated Hospital of China Medical University during the past 40 years were included in this study, among them, there were 42 cases of malignant tumors and 21 cases of benign tumors. The 61 patients underwent surgery including tracheal sleeve resection (22), carinal resection and reconstruction (6), semi-carinal resection and reconstruction (6), tracheal resection for tracheal tumors (17); tracheostomy (4), tracheal resection, partial resection of the thyroid (goiter) and esophagomyotomy (1), tracheal tumor resection and vertical hemilaryngectomy with reconstruction of laryngeal ventricle and trachea by sternocleidomastoid flap (2), cervical trachea and laryngeal resection (1), and carinal scrape (2).

RESULTSFifty-five patients had an uneventful recovery. Eight patients suffered from postoperative complications, among them 3 patients died postoperatively.

CONCLUSIONSPrimary tracheal tumors often present atypical symptoms, are easily misdiagnosed and with poor prognosis. The main aim of treatment remains to remove the airway obstruction.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Adenoid Cystic ; diagnosis ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; Chondroma ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Papilloma ; diagnosis ; surgery ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Survival Rate ; Tracheal Neoplasms ; diagnosis ; surgery ; Tracheotomy ; methods ; Young Adult

BACKGROUND AND OBJECTIVEAdenoid cystic carcinoma is primary bronchopulmonary carcinoma with low malignancy, and 43 patients treated in the past 50 years in our hospital were retrospectively studied. The aim of this study is to discuss the clinical symptoms, pathologic characteristic and therapeutic method of primary tracheal or bronchuotracheal adenoid cystic carcinoma.

METHODSThis study summarized total 43 patients of primary tracheal or bronchus adenoid cystic carcinoma treated in our hospital from Jan. 1958 to Dec. 2007. Among them, 40 patients were treated by surgical resection, and 3 patients were treated by fiberoptic bronchoscope's interventional treatment.

RESULTSThe 1-yr, 3-yr, 5-yr survival rates of the 43 patients above were 100% (41/41), 89.5% (34/38), 87.1% (27/31), respectively.

CONCLUSIONPrimary tracheal or bronchus adenoid cystic carcinoma are rare and low malignancy carcinoma. The clinical symptoms of them are not typical. The best treatment is early detection and taking measures of operation plus radiotherapy. The other palliative treatment is fiberoptic bronchoscope's interventional treatment.

Adult ; Aged ; Bronchial Neoplasms ; diagnosis ; mortality ; surgery ; Carcinoma, Adenoid Cystic ; diagnosis ; mortality ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Tomography, X-Ray Computed ; Tracheal Neoplasms ; diagnosis ; mortality ; surgery