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Ishibashi N, Tabata T, Nonomura R, Oshima Y, Sasaki T, Mitomo H, Sugawara T, Sagawa M, Sato N. Long-term follow-up of tracheal pleomorphic adenoma: A case report. Respir Med Case Rep 2024; 51:102073. [PMID: 39027816 PMCID: PMC11255949 DOI: 10.1016/j.rmcr.2024.102073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/20/2024] [Indexed: 07/20/2024] Open
Abstract
Pleomorphic adenomas occur primarily in the salivary glands, while the primary of the trachea is relatively rare. Depending on their location and size, they may elicit symptoms reminiscent of asthma and asphyxia. We performed a rigid bronchoscopic resection with a radiofrequency snare of a primary pleomorphic adenoma of the trachea with severe airway narrowing. In this case, the positive resection margins raised concerns about malignant transformation and local recurrence, but no recurrence has been observed seven years postoperatively. The low expression of Ki-67 on immunohistological examination may be one of the reasons for the absence of recurrence.
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Affiliation(s)
- Naoya Ishibashi
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Toshiharu Tabata
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Ryo Nonomura
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Yutaka Oshima
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Takanobu Sasaki
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Hideki Mitomo
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Takafumi Sugawara
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Motoyasu Sagawa
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Nobuyuki Sato
- Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan
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Liao QN, Fang ZK, Chen SB, Fan HZ, Chen LC, Wu XP, He X, Yu HP. Pleomorphic adenoma of the trachea: A case report and review of the literature. World J Clin Cases 2020. [DOI: 10.12998/wjcc.v8.i23.6021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Liao QN, Fang ZK, Chen SB, Fan HZ, Chen LC, Wu XP, He X, Yu HP. Pleomorphic adenoma of the trachea: A case report and review of the literature. World J Clin Cases 2020; 8:6026-6035. [PMID: 33344601 PMCID: PMC7723722 DOI: 10.12998/wjcc.v8.i23.6026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pleomorphic adenoma (PA) is the most common benign tumor that occurs in the salivary glands; however, tracheobronchial PA is rarely observed. To the best of our knowledge, fewer than 50 cases have been reported in the literature. We report a 49-year-old woman who had been treated for asthma for 2 years before being diagnosed with PA of the trachea.
CASE SUMMARY A 49-year-old woman was referred to our hospital due to dyspnea upon exertion and chronic cough with wheezing for 2 years. Laboratory tests showed an elevated white blood cell count, absolute neutrophil count, and percentage of neutrophils. A chest computerized tomography scan showed a well-defined, soft-tissue density lesion measuring 2.4 cm × 2.1 cm in the lower trachea. Flexible bronchoscopy revealed that nearly 90% of the tracheal lumen was obstructed. The histopathological and immunohistochemistry features suggested PA of the trachea. Furthermore, we review the characteristics of 29 patients with tracheobronchial PA over the last 30 years.
CONCLUSION Tracheobronchial PA occurs without gender predominance, mostly in the lower or upper trachea, and has a low recurrence rate. The median age at diagnosis is 48 years. The most common symptoms are cough, stridor, dyspnea, and wheezing.
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Affiliation(s)
- Qian-Nuan Liao
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Ze-Kui Fang
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Shu-Bing Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Hui-Zhen Fan
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Li-Chang Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Xi-Ping Wu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Xi He
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Hua-Peng Yu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
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Zhong H, Yan S, Jiang K, Hu Y, Dong X. A case report of bronchial pleomorphic adenoma in a child in China. BMC Pulm Med 2020; 20:295. [PMID: 33176739 PMCID: PMC7661225 DOI: 10.1186/s12890-020-01338-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Paediatric cases of pleomorphic adenoma of the bronchus are rare in clinical practice, despite pleomorphic adenoma being the most common histological form of salivary gland neoplasm. To date, no such cases have been reported in China. CASE PRESENTATION We report a case of pleomorphic adenoma of the bronchus in a 10-year-old child with no obvious positive signs on examination. Chest-enhanced computed tomography and bronchoscopy showed a large white mass in the right principal bronchus. The patient was treated by bronchial mass resection. Biopsy confirmed the diagnosis of pleomorphic adenoma. CONCLUSIONS We not only describe a rare benign bronchial tumour in children but also demonstrate the successful use of surgery as a radical cure for pleomorphic adenoma.
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Affiliation(s)
- Haiqin Zhong
- Department of Respiratory Medicine, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China
| | - Silei Yan
- Department of Respiratory Medicine, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China
| | - Kung Jiang
- Department of Respiratory Medicine, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China
| | - Yijing Hu
- Department of Respiratory Medicine, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, China.
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Issoufou I, Belliraj L, Harmouchi H, Ammor FZ, Lakranbi M, Ouadnouni Y, Smahi M. [Surgery of primary tracheal tumours of the salivary gland type]. Rev Mal Respir 2019; 36:547-552. [PMID: 30691699 DOI: 10.1016/j.rmr.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 09/05/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Primary tumours of the trachea are very rare and may develop from the tracheal salivary glands. CASE REPORTS We describe four patients operated on in our service between 2010 and 2017 of whom two had an adenocystic carcinoma, one a mucoepidermoid carcinoma and one a pleomorphic adenoma of the trachea. All were treated by resection and tracheal anastomosis with clear margins in three cases. The malignant cases received adjuvant treatment consisting of radiotherapy in one case and radiochemotherapy in the second. Immediate postoperative recovery was uncomplicated in all patients. One death followed the developement of post irradiation tracheal stenosis two years after surgery in a patient with an adenocystic carcinoma where the resection margins were invaded by tumour. CONCLUSIONS Resection and anastomosis of the trachea remains the best therapeutic option with a better prognosis when the resection is complete.
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Affiliation(s)
- I Issoufou
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc.
| | - L Belliraj
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc
| | - H Harmouchi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc
| | - F Z Ammor
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc
| | - M Lakranbi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc
| | - Y Ouadnouni
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc; Faculté de médecine et de pharmacie, université Sidi Mohamed Ben Abdellah, Fès, Maroc
| | - M Smahi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, Km 2.200, route de Sidi Harazem, 30000 Fès, Maroc; Faculté de médecine et de pharmacie, université Sidi Mohamed Ben Abdellah, Fès, Maroc
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Abstract
RATIONALE Tracheobronchial benign tumors are uncommon; particularly, bronchial pleomorphic adenoma is one of the rarest benign tumors that develop in bronchus (only 7 reported cases, among which only 4 cases of pleomorphic adenoma were seen arising from right main bronchus). PATIENT CONCERNS In this report, a 38-year-old woman suffered from progressive shortness of breath for 5 years due to right main bronchial pleomorphic adenoma. DIAGNOSES The patient was diagnosed as right main bronchial pleomorphic adenoma based on chest computed tomography enhanced scan, bronchoscopy, and histological examination. INTERVENTIONS An electrosurgical snare was performed to resect the neoplasm and several APC were administered at the sites of the resection to provide hemostasis and further coagulate for the residual neoplasm. OUTCOMES The patient was free of symptoms and the lumen of right main bronchus was clear during the follow-up period for 10 months without any procedure-related complications. LESSONS Bronchial pleomorphic adenoma is extremely rare, however, we should take it into consideration if a patient suffered from shortness of breath without an exact cause.
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Affiliation(s)
- Zhixing Zhu
- Department of Pulmonary and Critical Care Medicine
| | | | - Dongyong Yang
- Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospital of Fujian Medical University, Respiratory Medicine Center of Fujian Province, Licheng District, Quan Zhou, P.R. China
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