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Perez Ortiz GE, Del Toro Diez EF, Munet Colon C, Ríos de Choudens CS, Gorbea A, Lajud S. A Rare Case of Tracheal Lipoma in Puerto Rico: Presentation and Management of a Patient With Longstanding Respiratory Complaints. Cureus 2024; 16:e68010. [PMID: 39211823 PMCID: PMC11357836 DOI: 10.7759/cureus.68010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2024] [Indexed: 09/04/2024] Open
Abstract
Tracheal lipomas, though exceedingly rare among benign tracheal masses, present unique diagnostic and management challenges due to their unusual clinical course. This case report documents the presentation and surgical management of a 56-year-old male with a tracheal lipoma, a first documented case in Puerto Rico. The patient presented with progressive dyspnea and stridor, initially misdiagnosed and treated as asthma exacerbations. Imaging confirmed a pedunculated tracheal mass, prompting emergency surgical intervention to secure the airway and excise the mass successfully. Histopathological analysis confirmed the mass as a benign tracheal lipoma. This case emphasizes the importance of considering rare tracheal tumors in the differential diagnosis of unexplained respiratory distress and advocates for tailored management strategies informed by comprehensive multidisciplinary approaches.
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Affiliation(s)
- Giovanny E Perez Ortiz
- Department of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
| | - Edgar F Del Toro Diez
- Department of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
| | - Clariliz Munet Colon
- Department of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
| | - Camila S Ríos de Choudens
- Department of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
| | - Andres Gorbea
- Department of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
| | - Shayanne Lajud
- Department of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
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Ruenwilai P, Ekpumimas K. Tracheal Adenoid Cystic Carcinoma Successfully Treated With the Combined Core Out Technique, Cryoextraction, and Argon Plasma Coagulation: A Case Report. Cureus 2024; 16:e64150. [PMID: 39119440 PMCID: PMC11308734 DOI: 10.7759/cureus.64150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
We report the case of a 67-year-old male who presented with mild dyspnea two years ago, with increasing intensity, cough, and stridor on exertion. He underwent outpatient evaluation and received treatment for recurrent episodes of bronchitis and acute exacerbations of chronic obstructive pulmonary disease. His current medication included tiotropium 18 µg per day and salmeterol/fluticasone 50/500 µg twice daily. The patient received a short course of prednisolone at 40 mg per day for five days before admission. The physical examination showed a central stridor during both inspiration and expiration. Chest radiograph showed a normal lung parenchyma and no hilar enlargement. Spirometry revealed fixed airway obstruction. CT scan of the thorax revealed a 2.4 × 2.7 cm lobulated mass abutting the right side of the lower trachea with nearly complete obstruction. Due to the large tumor causing significant central airway obstruction, the medical team opted to remove the central airway mass through rigid bronchoscopy. Argon plasma coagulation was used to facilitate mass shrinkage. Mechanical mass removal was performed using a rigid bronchoscope. At the end of the treatment, re-evaluation by bronchoscopy exhibited no remaining mass. Histologic examination confirmed the diagnosis of a tracheal adenoid cystic carcinoma. No recurrence of the tumor was noted during 12 months of follow-up.
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Affiliation(s)
- Parinya Ruenwilai
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, THA
| | - Kulachat Ekpumimas
- Division of Respiratory Medicine, Central Chest Institute of Thailand, Nonthaburi, THA
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Fukumitsu K, Ning Y, Kanemitsu Y, Tajiri T, Okuda K, Fukuda S, Uemura T, Ohkubo H, Takemura M, Maeno K, Ito Y, Oguri T, Takakuwa O, Niimi A. Tracheal Glomus Tumor Complicated with Asthma Exacerbation in a Pregnant Woman. Intern Med 2022. [PMID: 36450466 PMCID: PMC10400392 DOI: 10.2169/internalmedicine.0510-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
A 34-year-old pregnant woman in the 34th week of gestation with uncontrolled asthma was admitted because of asthma exacerbation. Although she received bronchodilators and systemic corticosteroids, respiratory failure rapidly progressed. Chest computed tomography revealed a mass occluding approximately 80% of the tracheal lumen. After urgent Caesarean section, endobronchial resection was performed. The pathological findings of the resected tumor were compatible with tracheal glomus tumor. Tracheal tumors are often misdiagnosed as asthma, but its complication with asthma is rare. Even if the diagnosis of asthma is definitive, clinicians should consider coexisting diseases, including tracheal tumors, when asthma control is poor.
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Affiliation(s)
- Kensuke Fukumitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yangyi Ning
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Tomoko Tajiri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Katsuhiro Okuda
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Science, Japan
| | - Satoshi Fukuda
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Takehiro Uemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Hirotsugu Ohkubo
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Masaya Takemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Ken Maeno
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Tetsuya Oguri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Osamu Takakuwa
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
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Bezerra FG, Veloso AFDH, Dourado GAC, de Lima FEMM, Lima AMR. Tracheobronchial mucoepidermoid carcinoma: Case report and literature review. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2021. [DOI: 10.1016/j.cpccr.2021.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kim J, Park BY, Lim JA. Awake nasotracheal intubation under bronchoscopic guidance and anesthetic management in a patient undergoing excision of an endotracheal mass: A case report. Medicine (Baltimore) 2021; 100:e27734. [PMID: 34766581 PMCID: PMC10545392 DOI: 10.1097/md.0000000000027734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
RATIONALE The main challenge facing anesthesiologists during endotracheal mass resection is securing effective airway management during surgery. It is important to select an airway intubation and airway maintenance method according to the patient's condition and the characteristics of the mass. PATIENT CONCERNS A 74-year-old woman with aggravated dyspnea for 1 year was scheduled to undergo endotracheal mass excision under general anesthesia. DIAGNOSIS The mass was 4 × 3 × 3 cm ovoid-shaped, and located 4 cm above the carina, occupying 41% of the tracheal lumen in a preoperative chest computed tomography and bronchoscopy. INTERVENTIONS After preparing extracorporeal membrane oxygenation in case of the inability to ventilate and intubate, we attempted awake bronchoscopy-guided nasotracheal intubation using a reinforced endotracheal tube with an inner diameter of 5.5 mm and outer diameter of 7.8 mm after a translaryngeal block. The tube was passed around the mass without resistance and placed right above the carina. With the tube pulled back above the mass, another tube was introduced from the opened trachea below the mass to the right main bronchus. Following the resection of the tracheal portion containing the mass, the posterior wall of the remaining trachea was reconstructed. The tube placed in the right main bronchus was removed and the tube in the upper trachea was introduced right above the carina. The patient's head was kept flexed once the anastomosis of the trachea was completed, and the surgery ended uneventfully. OUTCOMES The mass was confirmed as schwannoma by histopathological finding. The patient was discharged from the hospital on the 6th postoperative day without complication. LESSONS Awake bronchoscopy-guided intubation is a safe airway management method in patients with an endotracheal mass. Close cooperation between anesthesiologist and surgeon, and preparation for airway management before surgery is essential. It is necessary to establish alternative plans that can be implemented in the case that intubation and ventilation are not possible.
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A case of adenoid cystic carcinoma of trachea: treatment complications and radiotherapy role. J Contemp Brachytherapy 2021; 13:588-592. [PMID: 34759984 PMCID: PMC8565636 DOI: 10.5114/jcb.2021.109853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 07/20/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose Adenoid cystic carcinoma (ACC) of trachea is a relatively rare malignant neoplasm, for which there is a lack of prospective clinical trials investigating treatment effectiveness. Most of the authors prefer surgical resection followed by post-operative radiation therapy in case of incomplete excision. There are no available prospective data on post-relapse treatment. Case presentation The current paper presents a case of tracheal ACC in a young woman, treated solely with surgical resection without radiotherapy due to postoperative neurological complications requiring additional diagnostics, management, and treatment. As a complication itself, spinal cord dysfunction after tracheal surgery is extremely rare, in which radical radiotherapy and brachytherapy were successfully administered after disease recurrence. Conclusions Lack of post-operative radiotherapy resulting from neurological complications could be a reason for ACC recurrence in our patient. Administration of radiotherapy after incomplete resection of recurrent disease may lead to long-term locoregional control.
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Santaella DMA, Johnson KL, Helgert ND, Morandi F, Whittemore JC. What Is Your Diagnosis? J Am Vet Med Assoc 2021; 258:365-367. [PMID: 33539211 DOI: 10.2460/javma.258.4.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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CARIBONI U, COSTANTINA E, ALLOISIO M, VOULAZ E. Early stage of intraluminal tracheal chondrosarcoma. Chirurgia (Bucur) 2021. [DOI: 10.23736/s0394-9508.19.04984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Marchionatti E, Van der Vekens E, Peters LM, Kaiponen TS, Berenguer Veiga I, Zanolari P. Solitary tracheal B-cell lymphoma in an adult alpaca (Vicugna pacos). BMC Vet Res 2020; 16:429. [PMID: 33167982 PMCID: PMC7653881 DOI: 10.1186/s12917-020-02640-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This report describes a case of solitary tracheal lymphoma in a 14-year-old alpaca mare. CASE PRESENTATION The alpaca was referred for dyspnea and inspiratory noise. The clinical examination included complete blood cell count, blood chemistry, endoscopy, ultrasound, radiographs, and computed tomography (CT). A solitary tracheal intraluminal and juxtatracheal lymphoma was diagnosed by fine needle aspiration (FNA). The owner requested euthanasia due to the uncertain prognosis. At postmortem examination, the presence of solitary lymphoma without involvement of other organs was confirmed. Immunohistochemical analysis confirmed a B-cell origin. CONCLUSIONS Although multicentric lymphoma is the most commonly described neoplasia affecting South American camelids (SAC), solitary forms of the disease may occur.
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Affiliation(s)
- Emma Marchionatti
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109A, 3012, Bern, Switzerland.
| | - Elke Van der Vekens
- Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland
| | - Laureen Michèle Peters
- Clinical Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland
| | - Taina Susanna Kaiponen
- Institute for Veterinary Pathology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland
| | - Inês Berenguer Veiga
- Institute for Veterinary Pathology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland
| | - Patrik Zanolari
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109A, 3012, Bern, Switzerland
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Hao ZR, Yao ZH, Zhao JQ, Li DZ, Wan YY, Kang YM, Lin DJ. Clinical efficacy of treatment for primary tracheal tumors by flexible bronchoscopy: Airway stenosis recanalization and quality of life. Exp Ther Med 2020; 20:2099-2105. [PMID: 32782522 PMCID: PMC7401314 DOI: 10.3892/etm.2020.8900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 01/06/2020] [Indexed: 01/09/2023] Open
Abstract
The aim of the present study was to evaluate the effectiveness of interventional treatment of primary tracheal tumors through flexible bronchoscopy. The clinical data of 38 patients with primary tracheal tumours who underwent flexible bronchoscopy intervention therapy between January 2011 and January 2017 were retrospectively analyzed. The average time interval from onset of symptoms to the appearance of actual clinical manifestations in the 38 patients ranged from 0 to 60 months, with an average of 8.1±11.6 months and a median of 4.2 months. The rate of misdiagnosis at the first visit was 36.8% (14/38). After interventional treatment, the overall efficiency (complete + partial response) of airway stenosis recanalization in the 38 patients was 89.5%. In 3 patients with benign tumors, the anhelation score was reduced following treatment (1.00±0.77 vs. 3.13±1.21 at the pre-treatment stage; P<0.001). The overall survival rates of the 35 patients at 1, 3 and 5 years were 69.3, 48.7 and 20.3%, respectively. Therefore, flexible bronchoscopic intervention may effectively smoothen the airways of patients and relieve the symptoms of anhelation. Combining radiotherapy and chemotherapy may improve patient prognosis and safety.
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Affiliation(s)
- Ze-Rui Hao
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.,Department of Respiratory Medicine, The Second People's Hospital of Liaocheng Affiliated to Taishan Medical College, Linqing, Shandong 252601, P.R. China
| | - Zhou-Hong Yao
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Jing-Quan Zhao
- Department of Respiratory Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, P.R. China
| | - De-Zhi Li
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yun-Yan Wan
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yan-Meng Kang
- Department of Respiratory Medicine, Qianfo Mountain Hospital, School of Medicine, Shandong University, Jinan, Shandong 250014, P.R. China
| | - Dian-Jie Lin
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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Rabiou S, Alami B, Efared B, Lakranbi M, Harmouchi H, El-Amrani R, Serraj M, El-Bouazzaoui A, Ouadnouni Y, Kanja N, Smahi M. How thoracic surgeon manage tracheal tumors in African country? (Case series). Ann Med Surg (Lond) 2019; 44:13-19. [PMID: 31289669 PMCID: PMC6593208 DOI: 10.1016/j.amsu.2019.06.007] [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: 03/14/2019] [Revised: 06/05/2019] [Accepted: 06/08/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction Tracheal tumors are a rare pathological entity whose diagnosis is usually delayed by clinical latency. Surgery, which consists of a tracheal resection-anastomosis with or without reconstructive reconstruction, remains the treatment that ensures the best long-term survival. Methods This is a retrospective study about 8 patients admitted in the department of thoracic surgery of Hassan II's university hospital of Fes for tracheal tumors management during 7 years time (December 2010 to December 2017). Results There were 6 men and 2 women with an average age of 44.4 years ranged from 17 to 65 years, 4 were smokers. Dyspnea was the main trigger sign. Seven (7) have undergone bronchial fibroscopy diagnostic with a finding of budding process in 5 patients, the middle of the trachea is often concerned in 3 patients, obstructing the lumen of the trachea in almost all patients. The treatment in all patients was surgical with an intubation via the operative field, 4 trachea resection-anastomosis, 4 plasty (Lateral resection with V plasty, Kergin's plasty, Mattey's tracheobronchial anastomosis and widened V-resection to the carina). The most common histological type in our series was Adenoid Cystic Carcinoma in 2 of our patients. For the other patients we have found squamous cell carcinoma (1 case), adenocarcinoma (1 case), atypical carcinoid tumor (1 case), low grade mucoepidermoid carcinoma (1 case), an adenoma pleomorph (1 case) and endotracheal goiter (1 case). The operative follow-up was simple in 7 of our patients, all of whom underwent post-operative fibroscopy within an average of 9 days. Two cases of post-operative recurrent palsy had been observed, all of which had progressed well under treatment. We have noted 2 deaths, including one at day 4 post-operative, and the other died from complications of post-radiation tracheal stenosis. Back to 32 months' average follow-up, we have enregistered a case of a distant relapse by cervical lymph node metastasis in one patient, 5 years after surgery. Conclusion Primary tumors of the trachea remain of reserved prognosis with 5-year survival of 57% of all histological types combined. Computed tomodensitometry and tracheobronchial fibroscopy remain the means of reference exploration in the diagnosis and assessment of surgical resectability.
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Affiliation(s)
- Sani Rabiou
- Department of Thoracic Surgery, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacy, Université de Niamey, Niger
| | - Badredine Alami
- Department of Radiology, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacies, Université Sidi Mohamed Ben Abdellah, Fez, Morocco
| | | | - Marwane Lakranbi
- Department of Thoracic Surgery, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacies, Université Sidi Mohamed Ben Abdellah, Fez, Morocco
| | | | - Rim El-Amrani
- Department of Thoracic Surgery, CHU Hassan II, Fez, Morocco
| | - Mounia Serraj
- Department of Pneumology, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacy, Université de Niamey, Niger
| | - Abderrahim El-Bouazzaoui
- Department of Anaesthesiology and Resuscitation A4, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacies, Université Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Yassine Ouadnouni
- Department of Thoracic Surgery, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacies, Université Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Nabil Kanja
- Department of Anaesthesiology and Resuscitation A4, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacies, Université Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Mohamed Smahi
- Department of Thoracic Surgery, CHU Hassan II, Fez, Morocco.,Faculty of Medicine and Pharmacies, Université Sidi Mohamed Ben Abdellah, Fez, Morocco
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Oliveira CM, Colaiácovo R, Araki O, Domene AFC, Mamede Filho DO, Saieg MA, Rossini LGB. The role of endoscopic ultrasound in the staging of tracheal neoplasm: a brief review. ACTA ACUST UNITED AC 2019; 65:589-591. [PMID: 31166431 DOI: 10.1590/1806-9282.65.5.589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/10/2018] [Indexed: 11/21/2022]
Abstract
Our case report shows the complexity of dealing with tracheal tumors, highlighting the importance of the method used for staging. In this report, endoscopic ultrasound (EUS) was crucial to identify the involvement of the esophageal muscular propria in a tracheal tumor and change the surgical planning of the case. Staging this kind of tumor represents a challenge for physicians. There is no evidence in the literature on which methods represent the gold standard for T staging.
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Affiliation(s)
- Cristiane Mota Oliveira
- EUS fellowship, French-Brazilian Center of Endoscopy (CFBEUS), Santa Casa of São Paulo, Brasil
| | - Rogerio Colaiácovo
- Assistant physician, French-Brazilian Center of Endoscopy (CFBEUS), Santa Casa of São Paulo, Brasil
| | - Osvaldo Araki
- Assistant physician, French-Brazilian Center of Endoscopy (CFBEUS), Santa Casa of São Paulo, Brasil
| | | | | | - Mauro Ajaj Saieg
- Associate Professor, Patology departament, Santa Casa Medical School, Brasil
| | - Lucio Giovanni Battista Rossini
- Head physician, French-Brazilian Center of Endoscopy (CFBEUS), Santa Casa of São Paulo, Brasil. Manager of the Endoscopy Service of the Sírio-Libanês Hospital, São Paulo, Brasil. Endoscopist at Samaritano Hospital, São Paulo, Brasil. Case report conducted at the French-Brazilian Center of Endoscopy (CFBEUS) and Endoscopy department of the Santa Casa of São Paulo, Brasil
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Piirainen KJ, Viitanen SJ, Lappalainen AK, Mölsä SH. Intraluminal tracheal lipoma as a rare cause of dyspnoea in a dog. Acta Vet Scand 2018; 60:59. [PMID: 30261909 PMCID: PMC6161456 DOI: 10.1186/s13028-018-0413-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Tracheal tumors are rarely diagnosed in veterinary medicine and the majority of tracheal neoplasia reported in adult dogs are malignant. Intratracheal lipoma has not been previously reported in the veterinary literature. Case presentation A 7-year-old Briard dog was evaluated for inspiratory dyspnoea and an inspiratory wheeze. Cervical radiographs and tracheoscopic examination revealed an intratracheal mass that was surgically removed. The dog has been asymptomatic after the surgery. Conclusions Based on histopathology, the mass was diagnosed as lipoma. To the authors‘ knowledge, this is the first published report of an intratracheal lipoma in the veterinary literature.
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A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia. Respir Med Case Rep 2018; 25:154-157. [PMID: 30175037 PMCID: PMC6115606 DOI: 10.1016/j.rmcr.2018.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor, and MECs of the lung are rare, accounting for 0.1–0.2% of malignant lung tumors. Pulmonary MECs are commonly found in the segmental or lobar bronchi, rarely presenting as endobronchial lesions. Case presentation Here we describe the case of a 21-year-old female with no comorbid conditions who presented at the emergency room with a cough, yellow phlegm, pleuritic chest pain, and a subjective fever. These symptoms had been present for approximately one week prior to the patient's arrival at the hospital. A chest X-ray revealed right lower lobe alveolar infiltrate and computed tomography of the chest showed dense consolidation of the right lower lobe with ovoid intraluminal density in the right main stem bronchus. Upon fiber optic bronchoscopy, an endobronchial lesion was found in the right main stem sparing the right upper lobe uptake. Endobronchial biopsy results was consistent with MEC of the lung. The patient underwent a bilobectomy with complete resection of the tumor. Conclusion Endobronchial MEC is a rare type of salivary gland tumor. Patients with low-grade MECs have a good prognosis, whereas those with high-grade MECs, which are aggressive and associated with metastatic disease, have a poor prognosis. However, early identification and surgical resection can result in a good prognosis.
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Joshua J, Scholten E, Schaerer D, Mafee MF, Alexander TH, Crotty Alexander LE. Otolaryngology in Critical Care. Ann Am Thorac Soc 2018; 15:643-654. [PMID: 29565639 PMCID: PMC6207134 DOI: 10.1513/annalsats.201708-695fr] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 03/22/2018] [Indexed: 01/02/2023] Open
Abstract
Diseases affecting the ear, nose, and throat are prevalent in intensive care settings and often require combined medical and surgical management. Upper airway occlusion can occur as a result of malignant tumor growth, allergic reactions, and bleeding events and may require close monitoring and interventions by intensivists, sometimes necessitating surgical management. With the increased prevalence of immunocompromised patients, aggressive infections of the head and neck likewise require prompt recognition and treatment. In addition, procedure-specific complications of major otolaryngologic procedures can be highly morbid, necessitating vigilant postoperative monitoring. For optimal outcomes, intensivists need a broad understanding of the pathophysiology and management of life-threatening otolaryngologic disease.
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Affiliation(s)
- Jisha Joshua
- Pulmonary and Critical Care Section, Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California; and
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Eric Scholten
- Pulmonary and Critical Care Section, Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California; and
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | | | - Mahmood F. Mafee
- Division of Neuroradiology, Department of Radiology, University of California–San Diego, San Diego, California
| | | | - Laura E. Crotty Alexander
- Pulmonary and Critical Care Section, Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California; and
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
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Abstract
Numerous benign and malignant tracheal diseases may affect the trachea primarily and secondarily. While the posterior anterior (PA) and lateral chest radiograph is the conventional study for initial evaluation of the trachea and central airways, findings may not always be apparent on conventional radiographs, and further evaluation with cross sectional imaging is usually necessary. Computed tomography (CT) is the imaging modality of choice for imaging the trachea and bronchi. Familiarity with the imaging appearances of the normal and diseased trachea will enhance diagnostic evaluation.
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Affiliation(s)
- Jo-Anne O Shepard
- Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Efren J Flores
- Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerald F Abbott
- Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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17
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Himeji D, Kawaguchi T, Setoguchi K, Koreishi S. Successful Treatment of Life-threatening Tracheal Stenosis Caused by Malignancy with a Self-expanding Hybrid Stent. Intern Med 2018; 57:259-263. [PMID: 29093400 PMCID: PMC5820047 DOI: 10.2169/internalmedicine.9164-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Tracheal stenosis caused by malignancy is a life-threatening complication. We performed stent therapy in two patients using the AERO™ stent, launched in late 2016 in Japan. One patient presented with stenosis of the trachea due to adenoid cystic carcinoma and the other with stenosis of the trachea due to esophageal cancer. Both patients showed improved symptoms, and no complications were identified. This is the first report of a favorable outcome with the use of this hybrid stent in Japan, and the findings suggest that insertion of the AERO hybrid stent is an effective way to improve patients' quality of life.
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Affiliation(s)
- Daisuke Himeji
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Takeshi Kawaguchi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Kensuke Setoguchi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Sakuya Koreishi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
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18
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Ivanovic AM, Stevic R, Popovic M, Stojsic J, Masulovic D, Jakovic R. Chronic Obstructive Pulmonary Disease Mismatch: A Case of Tracheal Hamartoma. Med Princ Pract 2017; 26:176-178. [PMID: 27685988 PMCID: PMC5588347 DOI: 10.1159/000452132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 09/29/2016] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To demonstrate the diagnostic challenge of tracheal hamartoma in a patient with chronic obstructive pulmonary disease (COPD). CLINICAL PRESENTATION AND INTERVENTION A 65-year-old man with COPD was admitted with sudden onset of asphyxia attacks related to the position of his body. Computerized tomography (CT) of the neck showed a soft tissue mass with calcification, which occluded more than two-thirds of the proximal part of the trachea. The tumor was completely removed, and histopathology confirmed hamartoma. CONCLUSION This case report showed the detection of a primary tracheal tumor on CT. This finding enabled the correct diagnosis and led to appropriate treatment in the form of surgery.
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Affiliation(s)
- Aleksandar M. Ivanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Center of Radiology and Magnetic Resonance Imaging, Belgrade, Serbia
- *Aleksandar M. Ivanovic, Center of Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Jurija Gagarina St. 220/59, RS-11070 Belgrade (Serbia), E-Mail
| | - Ruza Stevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Center of Radiology and Magnetic Resonance Imaging, Belgrade, Serbia
| | | | - Jelena Stojsic
- Department of Pathology, Clinical Center of Serbia, Belgrade, Serbia
| | - Dragan Masulovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Center of Radiology and Magnetic Resonance Imaging, Belgrade, Serbia
| | - Radoslav Jakovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Thoracic Surgery, Belgrade, Serbia
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19
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Abstract
Tumors of trachea and bronchi are uncommon and can occur in the form of benign or low- and high-grade malignant tumors. Although tracheobronchial tumors (TBTs) represent only 0.6% of all pulmonary tumors, they are clinically significant. Delays in diagnosis of these tumors commonly occur because the signs and symptoms caused by these tumors are nonspecific and chest radiographs are often considered unremarkable. Therefore, novel radiological techniques and better access to flexible bronchoscopy enable detection of larger number of TBT. The purpose of this article is to provide a review of tracheal and bronchial tumors and discuss significant aspects of the different TBT with focus on clinical manifestations and diagnostic procedures.
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Affiliation(s)
- Ruza Stevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia;; Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia
| | - Branislava Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia;; Clinic for Pulmonology, Clinical Center of Serbia, Belgrade, Serbia
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20
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Lin CH, Chao YH, Wu KH, Lin WC. Primary mucoepidermoid carcinoma at the carina of trachea presenting with wheezing in an asthmatic child mimicking an attack of asthma: A case report. Medicine (Baltimore) 2016; 95:e5292. [PMID: 27858901 PMCID: PMC5591149 DOI: 10.1097/md.0000000000005292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Asthma is a very common disease, but primary tracheal tumors are extremely rare in children. Wheezing is not pathognomonic, but is the typical presentation of asthma and could also be found in patients with tracheal tumors. CLINICAL FINDINGS This report describes a 12-year-old boy with a previous history of frequent asthma attacks and experienced responses to antiasthma treatment. He was admitted to the hospital due to persistent wheezing and progressive dyspnea. Hyperinflation in the bilateral lungs was detected on chest x-ray, but without other significant findings. Chest computed tomography revealed a mass at the carina. Tracheal mucoepidermoid carcinoma was diagnosed by histopathological assessment. CONCLUSION Despite the rarity of tracheal tumors, chest computed tomography scans should be performed in the first place for children presenting persistent wheezing and having poor response to antiasthma treatment to rule out the other alternative diagnosis. Coexistence of other diseases such as tracheal tumor in asthmatic patients should be considered.
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Affiliation(s)
- Chien-Heng Lin
- Division of Pediatric Pulmonology, China Medical University Children's Hospital
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University
| | - Yu-Hua Chao
- Department of Pediatrics, Chung Shan Medical University Hospital
- School of Medicine, Chung Shan Medical University
| | - Kang-Hsi Wu
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University
- Division of Pediatric Hematology-Oncology, China Medical University Children's Hospital
| | - Wei-Ching Lin
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University
- Department of Radiology, China Medical University Hospital
- School of Medicine, China Medical University, Taichung, Taiwan
- Correspondence: Wei-Ching Lin, Department of Radiology, China Medical University Hospital, Taichung, Taiwan, Address: No 2, Yuh-Der Road, Taichung 404, Taiwan (e-mail: )
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21
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Shroff GS, Ocazionez D, Vargas D, Carter BW, Wu CC, Nachiappan AC, Gupta P, Restrepo CS. Pathology of the Trachea and Central Bronchi. Semin Ultrasound CT MR 2016; 37:177-89. [DOI: 10.1053/j.sult.2015.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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22
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Bottero E, Cagnasso A, Gianella P. Diode laser ablation of a tracheal osteochondroma in a dog. J Small Anim Pract 2016; 57:382-5. [DOI: 10.1111/jsap.12485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/04/2015] [Accepted: 01/28/2016] [Indexed: 12/12/2022]
Affiliation(s)
- E. Bottero
- Poliambulatorio Veterinario Argentina; Via Levà 58 Arma di Taggia Imperia Italy
| | - A. Cagnasso
- Department of Veterinary Sciences; University of Turin; Largo P. Braccini 2, Grugliasco 10095 Turin Italy
| | - P. Gianella
- Department of Veterinary Sciences; University of Turin; Largo P. Braccini 2, Grugliasco 10095 Turin Italy
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23
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Abstract
We report a 63-year-old woman who presented with 1 month of non-productive cough and non-bloody diarrhea. She was on maintenance therapy for a 15-year history of Crohn's disease. Treatment with systemic corticosteroids resulted in rapid improvement of both her diarrhea and respiratory symptoms. Our patient is unique in that she presented with tracheobronchitis during an acute flare of her Crohn's without obvious lung pathology on chest imaging. Tracheobronchitis is a rare manifestation of inflammatory bowel disease that should be considered in Crohn's disease patients presenting with persistent non-infectious cough.
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24
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Cassler NM, Marquart JD, Carter CA. Tracheal squamous cell carcinoma (SCC) metastatic to the skin in a patient on a checkpoint inhibitor. JAAD Case Rep 2016; 1:308-9. [PMID: 27051762 PMCID: PMC4809275 DOI: 10.1016/j.jdcr.2015.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nicole M Cassler
- Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Jason D Marquart
- Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Corey A Carter
- Department of Hematology-Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland
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25
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Abstract
Malignant tracheal neoplasms are rare diseases, mostly represented by squamous cell carcinoma (SCC) and adenoid cystic carcinoma (ACC). Symptoms presentation is often misleading and diagnosis may be delayed for months or years, so clinical suspicion plays a fundamental role. Corner stones in the diagnostic pathway are represented by rigid endoscopy and computed tomography (CT) scan, necessary to correctly stage the patients and identify the optimal surgical candidate. When appropriate, surgical resection and reconstruction is still the best opportunity to achieve a long-term survival with a good quality of life, but this kind of surgery is always a very challenging procedure and a wide experience with an in-depth knowledge of every technical detail, from selection of patient, to choice of surgical approach to reconstruction techniques, are needed and recommended.
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Affiliation(s)
- Federico Rea
- Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Andrea Zuin
- Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy
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26
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Abstract
PURPOSE OF REVIEW This article reviews the current literature for the purpose of developing a practical approach for the diagnosis and management of primary tracheal tumors. RECENT FINDINGS Because of nonspecific symptoms, tracheal tumors remain a diagnostic challenge. Currently available management strategies are not being optimally utilized due to lack of physician awareness and knowledge. The use of newer diagnostic modalities has increased diagnostic accuracy resulting in earlier detection in recent years. This review describes currently available diagnostic modalities along with relatively newer ones such as virtual bronchoscopy, anatomic Optical Coherence Tomography, spectroscopic techniques, and endobronchial ultrasonography. We will review and discuss management strategies including surgical options, adjuvant therapies, and interventional pulmonary techniques including their role in palliation. SUMMARY Early detection along with improved surgical and interventional pulmonology techniques has led to a decline in the death rates from tracheal cancer in recent years. However, further studies are required to define the role of chemotherapeutic agents, combination therapies, and novel techniques such as tracheal transplantation, in the management of primary tracheal tumors. More robust evidence-based studies are needed to provide evidence for clinical practice guidelines for the treatment of primary tracheal tumors.
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27
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Kim JJ, Moon SW, Kim YH, Choi SY, Jeong SC. Flexible bronchoscopic excision of a tracheal mass under extracorporeal membrane oxygenation. J Thorac Dis 2015; 7:E54-7. [PMID: 25922751 DOI: 10.3978/j.issn.2072-1439.2015.01.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/15/2014] [Indexed: 01/25/2023]
Abstract
Tracheal tumor is a rare but life-threatening condition that can cause obstruction of the airway. Management of tracheal tumors is very challenging and includes surgical resection, radiotherapy, and therapeutic bronchoscopy. Herein, we present a very rare case of an 88-year-old female patient with a tracheal mass due to direct invasion of a mediastinal teratoma. We devised a new method for resection of the tracheal mass because management of her airway and the tracheal mass by conventional methods was impossible. We successfully resected the tracheal mass with flexible bronchoscopic electrocautery under extracorporeal membrane oxygenation (ECMO) without any complications. When management of a patient's airway and tracheal mass are impossible by conventional methods, this technique may be very useful.
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Affiliation(s)
- Jae Jun Kim
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Seok Whan Moon
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Yong Hwan Kim
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Si Young Choi
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
| | - Seong Cheol Jeong
- 1 Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea
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