Tracheal (windpipe) CancerInformation for Patients and the Public
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MeSH term: Tracheal Neoplasms
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This list of publications is regularly updated (Source: PubMed).
The role of endoscopic ultrasound in the staging of tracheal neoplasm: a brief review.
Rev Assoc Med Bras (1992). 2019; 65(5):589-591 [PubMed] Related Publications
Image-guided volumetric modulated arc therapy (IG-VMAT) for unresectable ACC of the trachea: a feasible curative option.
BMJ Case Rep. 2019; 12(3) [PubMed] Related Publications
Combined surgery and radiotherapy as curative treatment for tracheal adenoid cystic carcinoma: a case report.
J Med Case Rep. 2019; 13(1):52 [PubMed] Free Access to Full Article Related Publications
CASE PRESENTATION: We report a case of an 82-year-old white man affected by primary adenoid cystic carcinoma of the trachea, treated with debulking surgery and radiotherapy on the residual disease. A three-dimensional conformal radiation therapy was conducted. The total dose amounted to 70 Gy, administered in 35 fractions of 2 Gy. The medium doses given to the esophagus and lungs were 23 Gy and 4.2 Gy respectively. The maximum dose delivered to the spinal cord was 31 Gy with satisfactory results in terms of local control of the disease.
CONCLUSION: A combined approach of surgical resection followed by radiotherapy on the residual disease provided an excellent result in terms of disease control, quality of life, and overall survival in a patient with locally advanced tracheal adenoid cystic carcinoma.
Hybrid bronchoscopic and surgical resection of endotracheal angiomatoid fibrous histiocytoma.
J Cardiothorac Surg. 2019; 14(1):48 [PubMed] Free Access to Full Article Related Publications
CASE PRESENTATION: We present a case of a 22-year-old female with AFH in the distal trachea. In addition to describing the challenge in making a correct diagnosis of AFH, we describe the first case of successful hybrid bronchoscopic and surgical resection of endotracheal AFH. A staged removal procedure was required to quickly secure the airway, allowing a lower-risk elective distal tracheal resection through a cervical approach for complete resection. A more conventional, but more invasive, more painful and cosmetically less satisfying thoracotomy was avoided.
CONCLUSIONS: A distal tracheal resection for AFH can be safely performed in young adults through a cervical approach with excellent follow-up results.
Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma.
BMJ Case Rep. 2019; 12(1) [PubMed] Free Access to Full Article Related Publications
Emergency Tracheal Surgery for Adenoid Cystic Carcinoma: A Rare Entity.
J Coll Physicians Surg Pak. 2018; 28(11):882-884 [PubMed] Related Publications
Large endotracheal tumour presenting as severe COPD: flow-volume loop analysis, not always a straightforward diagnostic test.
BMJ Case Rep. 2018; 2018 [PubMed] Related Publications
Primary intratracheal schwannoma resected during bronchoscopy using argon plasma coagulation.
BMJ Case Rep. 2018; 2018 [PubMed] Related Publications
Immediate tracheal reconstruction with forearm flap and bone graft.
Microsurgery. 2019; 39(1):46-52 [PubMed] Related Publications
METHODS: Eleven patients (mean age, 64 years; range, 46-80 years) were included. Primary diagnoses included thyroid cancer and adenoid cystic carcinoma of the trachea. All defects were partial and located in the neck (mean width and length, 3/5 circle and 7.5 rings; range, 1/2-2/3 circle and 5-9 rings). Immediate 2-stage reconstruction was performed using a forearm flap and free bone graft. The bone graft was utilized as a supportive skeleton. A tracheostoma was left open for several months following the initial surgery, and then closed.
RESULTS: The mean flap size was 6.1 × 9.7 cm (range, 6-7 × 7-16 cm). Mean number of grafted bone strips and length were 1.6 (range, 1-3) and 6.1 cm (range, 4.5-7 cm). All flaps survived. Five patients developed complications in the neck, including surgical site infections (SSIs), recurrent nerve palsy, and lymphorrhea. Four patients developed donor site complications, including clavicular fracture and SSIs. Mean postoperative follow-up lasted 85 months (range, 11-149 months). Normal speech was restored in 9 patients. Stoma closure was abandoned in 2 patients, because 1 patient showed vocal cord fixation with advanced age and the other showed bone graft loss following SSI.
CONCLUSIONS: Creating a tracheostoma during the first operation prevents postoperative airway compromise. Our bone graft placement easily achieves tracheal rigidity. This procedure is simple and safe for tracheal window defect repair.
NUT (Nuclear Protein in Testis) Carcinoma: A Report of Two Cases With Different Histopathologic Features.
Int J Surg Pathol. 2019; 27(2):225-229 [PubMed] Related Publications
Management of Malignant Tracheoesophageal Fistula.
Thorac Surg Clin. 2018; 28(3):393-402 [PubMed] Related Publications
Long-Term Outcome of Definitive Chemoradiotherapy and Induction Chemoradiotherapy Followed by Surgery for T4 Esophageal Cancer with Tracheobronchial Invasion.
Ann Surg Oncol. 2018; 25(11):3280-3287 [PubMed] Related Publications
PATIENTS AND METHODS: From 2003 to 2013, 71 patients with T4 EC with TBI were treated in our institution; 58 underwent dCRT, and 13 underwent iCRT-S. The long-term results associated with survival were retrospectively analyzed, and prognostic factors were examined by univariable and multivariable analysis.
RESULTS: The 1-, 2-, and 5-year overall survival for all patients with T4 EC with TBI treated by dCRT or iCRT-S was 57, 29, and 19%, respectively. Multivariable analysis revealed that clinical lymph node (LN) metastasis and the treatment period were significant prognostic factors. Clinical LN positivity had significantly poorer prognosis than LN negativity. The treatment outcome in the later period was significantly better than that in the earlier period. In particular, the outcome after dCRT revealed significantly better prognosis in the later compared with the earlier period, whereas the outcome after iCRT-S did not show such a difference. With respect to treatment modality, no significant difference in survival was observed between dCRT and iCRT-S.
CONCLUSIONS: Clinical LN negativity and later treatment period were significantly good prognostic factors for T4 EC with TBI. The recent improvements in dCRT outcomes may help to achieve survival comparable to that of iCRT-S.
Transtracheal endoscopic-assisted resection of a rare inflammatory myofibroblastic tumour in adult trachea: a case report.
Acta Otorhinolaryngol Ital. 2018; 38(2):170-173 [PubMed] Free Access to Full Article Related Publications
Tracheal chondrosarcoma and surgical management.
Asian Cardiovasc Thorac Ann. 2019; 27(1):52-54 [PubMed] Related Publications
Alterations of Notch pathway in patients with adenoid cystic carcinoma of the trachea and its impact on survival.
Lung Cancer. 2018; 121:41-47 [PubMed] Related Publications
METHODS: 73 Patients with ACC of the trachea at four institutions from 2008 to 2016 were identified. Analysis of hotspot mutations in cancer-related genes of Notch pathway was performed using next generation sequencing. Gene-expression and functional analyses were performed to study the mechanism of activation through mutation. Univariable and multivariable Cox regression models were used to predict overall survival (OS). Patient-derived xenograft (PDX) models were established and treated with NOTCH inhibitor Brontictuzumab.
RESULTS: Gain-of-function mutations of the NOTCH1 gene occurred in 12 (16.4%) tumors, leading to stabilization of the intracellular cleaved form of NOTCH1 (ICN1). NOTCH1 mutation was associated with increased NOTCH1 activation and its target gene HES1. Mutations in NOTCH2 (3/73), NOTCH4 (2/73), JAG1 (1/73) and FBXW7 (2/73) were also identified in 8 (11.0%) patients. A strong inverse correlation of expression was observed between FBXW7 and HES1. NOTCH1 mutation was associated with solid subtype (P = 0.02), younger age at diagnosis (P = 0.041) and shorter overall survival (OS) (P = 0.017). NOTCH1 mutation was not an independent prognostic factor in the presence of histologic subtype and resection margin. Brontictuzumab significantly reduced tumor growth in NOTCH1-mutated PDX.
CONCLUSION: NOTCH1 mutation is associated with activation of Notch pathway in ACC of the trachea. NOTCH1 is a potential target for therapeutic intervention in patients with ACC of the trachea.
Thoracic oesophageal cancer as a cause of stridor: a literature review.
BMJ Case Rep. 2018; 2018 [PubMed] Related Publications
Mucosa-associated lymphoid tissue lymphoma of the trachea associated with idiopathic pulmonary fibrosis: A case report and literature review.
Medicine (Baltimore). 2018; 97(20):e10727 [PubMed] Free Access to Full Article Related Publications
PATIENT CONCERNS: A 73-year-old patient visited with a 2-year history of dyspnea on exertion and productive cough, which had worsened 1 month ago.
DIAGNOSES: MALT lymphoma of the trachea associated with IPF.
INTERVENTIONS: After taking into consideration the age, poor performance status, and comorbidities of the patient and the extent of disease, we utilized an observational approach as a treatment strategy.
OUTCOMES: The patient is well without any evidence of progression for 12 months since the initial diagnosis.
LESSONS: We present a case of MALT lymphoma of the trachea associated with IPF. A common predisposing factor may exist for tracheal MALT lymphoma and IPF. As there are no randomized clinical trials focusing on tracheal MALT lymphoma, individualized treatment decision is important, and in some cases, simply monitoring the patient might be the most appropriate approach.
Bronchoscopic resection of a tracheobronchial leiomyoma in a pregnant patient.
Int J Obstet Anesth. 2018; 35:93-96 [PubMed] Related Publications
Treatment of an obstructive, recurrent, syncytial myoepithelioma of the trachea with tracheal resection and reconstruction.
Int J Pediatr Otorhinolaryngol. 2018; 109:85-88 [PubMed] Related Publications
Treatment of primary tracheal glomus tumors: Two case reports and a literature review.
Medicine (Baltimore). 2018; 97(15):e0374 [PubMed] Free Access to Full Article Related Publications
PATIENT CONCERNS: A 30-year old man who presented with cough, and expectoration for 1 month, and who had been diagnosed as having a tracheal neoplasm by cervical, and thoracic computed tomography (CT). The patient was a47 years old man. He was admitted to our hospital presenting with intermittent hemoptysis for 3 years. Thoracic CT revealed a round tumor on the right posterior tracheal wall.
DIAGNOSES: Both of them were diagnosed as benign GTs. Histopathology of the tumor showed clusters of round epithelioid cells with eosinophilic cytoplasm, and uniform round to ovoid nuclei surrounding dilated capillaries. Immunohistochemical staining was positive for smooth muscle actin (SMA).
INTERVENTIONS: The tracheal tumor of first patient was located at the level of C7-T1. Tumor resection was performed under fiberoptic bronchoscopy. The tracheal tumor in second patient was located in the lower trachea. Surgical tracheal resection and anastomosis were performed.
OUTCOMES: Both of them achieved good results and no recurrence was seen at the final follow-up LESSONS:: We recommend choosing the most appropriate approach to manage tracheal GTs based on patients' general condition, and tumor characteristics to obtain an excellent prognosis. Our 2 cases of tracheal GT were managed by different approaches, and both achieved good results.
Pathology of Primary Tracheobronchial Malignancies Other than Adenoid Cystic Carcinomas.
Thorac Surg Clin. 2018; 28(2):149-154 [PubMed] Related Publications
Biology of Adenoid Cystic Carcinoma of the Tracheobronchial Tree and Principles of Management.
Thorac Surg Clin. 2018; 28(2):145-148 [PubMed] Related Publications
Unique application of awake tracheoscopy and endobronchial ultrasound in the management of tracheal mucoepidermoid carcinoma.
Head Neck. 2018; 40(6):E58-E61 [PubMed] Related Publications
METHODS AND RESULTS: We present a 17-year-old girl with primary tracheal mucoepidermoid carcinoma presenting in acute respiratory distress due to near-total occlusion of the tracheal airway. An algorithmic approach to preoperative planning was developed to evaluate and remove the tumor endoscopically without compromising oxygenation. After initial palliative resection, endobronchial ultrasound was uniquely applied to evaluate depth of tumor invasion, and subsequent tracheal resection with primary anastomosis was performed as curative treatment.
CONCLUSION: Removal of distal tracheal masses can be performed safely with the implementation of an algorithmic approach to tumor visualization and resection. Endobronchial ultrasound can be used to evaluate the extent of tumor invasion and plan for definitive resection.
Rare case of radiation-induced primary tracheal carcinoma.
Gen Thorac Cardiovasc Surg. 2018; 66(9):549-551 [PubMed] Related Publications
Thoracoscopic Tracheal Resection and Reconstruction With Single-Incision Method.
Ann Thorac Surg. 2018; 106(1):e45-e47 [PubMed] Related Publications
Extramedullary plasmacytoma of the trachea: A case report and review of the literature.
Medicine (Baltimore). 2018; 97(3):e9594 [PubMed] Free Access to Full Article Related Publications
PATIENT CONCERNS: In this report, we describe a case of tracheal EMP discovered in a 48-year-old man who presented with a history of progressive dyspnea.
DIAGNOSES: Computed tomography (CT) revealed a well-defined nodular mass in the posterior wall of trachea without signs of invasion of the tracheal walls. Then, a reddish mass occluding approximately 90% of the trachea was evidenced by bronchoscopic examination.
INTERVENTIONS: The patient was treated with surgery followed by adjuvant radiotherapy to achieve better local control.
OUTCOMES: After the surgery, there was immediate symptomatic relief. There was no recurrence or metastasis during a 6-month follow-up.
LESSONS: This study presents a rare case of tracheal EMP occluding approximately 90% of the lumen that was successfully managed by surgery followed by radiotherapy.
Tracheal paraganglioma presenting as stridor in a pediatric patient, case report and literature review.
Int J Pediatr Otorhinolaryngol. 2018; 107:145-149 [PubMed] Related Publications
METHODS: Chart review of an 8-year-old male who presented to a tertiary care pediatric hospital and literature review of tracheal paragangliomas.
RESULTS: We present the case of an 8-year-old male who presented with new-onset of wheezing and dyspnea on exertion. He was given a new diagnosis of asthma and treated with bronchodilators that failed to improve his symptoms, which progressed over 3 months until he presented urgently with biphasic stridor. Bedside flexible laryngoscopy failed to reveal an etiology. Computed tomography (CT) imaging demonstrated 17 × 12 × 16 mm exophytic mass arising from the posterior membranous trachea with extension of the mass to the border of the thyroid gland and separate from the esophagus. Magnetic resonance imaging (MRI) angiography confirmed vascular supply from the right thyrocervical trunk and inferior thyroid artery. Rigid microlaryngoscopy revealed a friable vascular polypoid mass 2 cm distal to the vocal folds with 75% obstruction of the airway from which a small biopsy was taken. Pathology confirmed paraganglioma with neuroendocrine cells arranged in "zellballen" architecture and strong immunopositivity for chromogranin and synaptophysin in the neuroendocrine cells and S100 immunopositivity in the sustentacular cells. The patient underwent complete open resection of the tumor including three tracheal rings with primary anastomosis. Final pathology confirmed paraganglioma and negative margins. Genetic screening revealed a succinate dehydrogenase complex subunit C (SDHC) germline mutation, confirming hereditary paraganglioma/pheochromocytoma syndrome. He remains well at 3 month follow up without dyspnea or stridor.
CONCLUSION: Tracheal paragangliomas are exceptionally rare, with 12 reported cases. This is the only pediatric case reported. In pediatric patients with persistent airway complaints, subglottic and tracheal masses and obstruction should be considered. Due to the vascularity and endotracheal component of tracheal paragangliomas, a detailed surgical plan should consider embolization, endotracheal laser photocoagulation and electrocautery, and open surgical resection. Additionally, pediatric patients benefit from a multidisciplinary approach including radiology, endocrinology, and genetic counseling.
Long-Segment Tracheal Reconstruction With Free Radial Forearm Flap Reinforced by Rib Cartilage.
Ann Plast Surg. 2018; 80(5):525-528 [PubMed] Related Publications
Rare Case of Intratracheal Metastasis Detected on 68Ga-Prostate-Specific Membrane Antigen PET/CT Scan in a Case of Thyroglobulin Elevated Negative Iodine Scan Syndrome.
Clin Nucl Med. 2018; 43(4):282-283 [PubMed] Related Publications
Use of Univent tube for intermittent lung isolation during thoracoscopic mediastinal tracheal resection and reconstruction: A case report.
Medicine (Baltimore). 2017; 96(50):e8945 [PubMed] Free Access to Full Article Related Publications
PATIENT CONCERNS: The authors describe a novel technique of lung isolation and ventilation with a Univent tube during thoracoscopic mediastinal tracheal resection and reconstruction in a female patient.
DIAGNOSES: Primary tracheal adenoid cystic carcinoma, nonsmall cell carcinoma.
INTERVENTIONS: In this case, tracheal resection and reconstruction were performed. A bronchial blocker of the Univent tube was used as a guide to manipulate the depth of endotracheal tube.
OUTCOMES: The intermittent 1-lung ventilation was established successfully. The patient recovered uneventfully and discharged after 10 days.
LESSONS: The advantages of approach include a stable airway management without occupying the contracted space of thoracoscope and no potential risk of trapping or barotraumas.