1
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Piórek A, Płużański A, Knetki-Wróblewska M, Winiarczyk K, Tabor S, Teterycz P, Kowalski DM, Krzakowski M. Treatment outcomes of patients with primary tracheal tumors - analysis of a large retrospective series. BMC Cancer 2024; 24:686. [PMID: 38840114 PMCID: PMC11155021 DOI: 10.1186/s12885-024-12450-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE Primary tracheal tumors are very rare and their management is not definitely established. Due to its rarity, providing patient care in terms of optimal management poses a considerable challenge. The purpose of this study was to investigate treatment outcomes in patients with these rare tumors. METHODS We carried out a retrospective analysis of 89 patients with primary tracheal tumors treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, over sixteen years. The study assessed patient demographics, tumor characteristics and treatment. Different treatment options were compared in terms of overall survival, disease-free survival, and progression-free survival. RESULTS A total of 89 patients were included in the study. In the group presented, 45 patients underwent primary radical treatment and 44 were qualified for palliative treatment. Surgical resection was performed in 13 patients out of radically treated patients. The 5 year OS rates in the group of patients who underwent radical treatment and in the group of patients who underwent palliative treatment were 45.9% and 2.3%, respectively. In the group of patients who underwent radical surgical treatment, the 5 year OS was 76.9% compared to 35.8% in the group of patients who underwent nonsurgical treatment. CONCLUSION A multidisciplinary team should decide treatment options, including in-depth consideration of surgical treatment options.
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Affiliation(s)
- Aleksandra Piórek
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland.
| | - Adam Płużański
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
| | - Magdalena Knetki-Wróblewska
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
| | - Kinga Winiarczyk
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
| | - Sylwia Tabor
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
| | - Paweł Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
- Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
| | - Dariusz M Kowalski
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
| | - Maciej Krzakowski
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
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2
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Eichhorn F, Hoffmann H, Rieken S, Herth FJF, Winter H. [Tracheal Tumours]. Zentralbl Chir 2024; 149:286-297. [PMID: 38382560 DOI: 10.1055/a-2223-1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Malignant primary tracheal tumours are rare. The most common histological subtypes are squamous cell carcinoma and adenoid cystic carcinoma. These two entities have different prognoses and growth patterns. Tracheobronchoscopy and thoracic sectional imaging are standard diagnostic tools for tumour staging and local evaluation. Complete surgical resection of the affected tracheal segment is the treatment of choice for limited disease without distant metastases. Incomplete gross tumour resection with additional irradiation is an acceptable therapeutic option for adenoid cystic carcinoma. Interventional endoscopy with tumour debulking or tracheal stenting and/or definitive mediastinal radiotherapy are treatment alternatives in either a locally advanced or palliative setting.
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MESH Headings
- Tracheal Neoplasms/surgery
- Tracheal Neoplasms/pathology
- Tracheal Neoplasms/diagnosis
- Tracheal Neoplasms/therapy
- Tracheal Neoplasms/diagnostic imaging
- Humans
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/surgery
- Carcinoma, Adenoid Cystic/diagnostic imaging
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Adenoid Cystic/diagnosis
- Bronchoscopy
- Neoplasm Staging
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/therapy
- Carcinoma, Squamous Cell/diagnostic imaging
- Trachea/surgery
- Trachea/pathology
- Trachea/diagnostic imaging
- Prognosis
- Combined Modality Therapy
- Tomography, X-Ray Computed
- Stents
- Palliative Care
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Affiliation(s)
- Florian Eichhorn
- Abteilung für Thoraxchirurgie, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Deutschland
| | - Hans Hoffmann
- Sektion Thoraxchirurgie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Stefan Rieken
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universität Göttingen, Medizinische Fakultät, Göttingen, Deutschland
| | - Felix J F Herth
- Abteilung für Pneumologie und Beatmungsmedizin, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Deutschland
| | - Hauke Winter
- Abteilung für Thoraxchirurgie, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Deutschland
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3
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Lopez-Pastorini A, Stoelben E. [Carinal Resections]. Zentralbl Chir 2024; 149:298-307. [PMID: 38359867 DOI: 10.1055/a-2240-9974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Carinal resections are consistently described in the literature as one of the most challenging procedures in thoracic surgery. Depending on the underlying disease and its extent, different resection forms and reconstruction techniques are required. From a surgical point of view, the complex anatomy, and the technique of reconstruction of the central airway are particularly challenging. However, complex airway management and extensive postoperative follow-up demonstrate that these procedures require a multidisciplinary team effort beyond surgical expertise. This article reviews the most important pre-, intra-, and post-operative aspects of these challenging procedures.
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Affiliation(s)
| | - Erich Stoelben
- Thoraxklinik Köln, St. Hildegardis-Krankenhaus, Köln, Deutschland
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4
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Piórek A, Płużański A, Teterycz P, Tabor S, Winiarczyk K, Knetki‐Wróblewska M, Kowalski DM, Krzakowski M. Clinicopathological characteristics of patients with primary tracheal tumors: Analysis of eighty-nine cases. Thorac Cancer 2024; 15:878-883. [PMID: 38429910 PMCID: PMC11016403 DOI: 10.1111/1759-7714.15231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Primary tracheal tumors are very rare and the literature on this subject is limited. The most common histological type of primary tracheal tumors is squamous cell carcinoma (SCC), followed by adenoid cystic carcinoma (ACC). Limited knowledge exists regarding the behavior and outcomes of different histological types of tracheal cancers. The present study aimed to address this gap by assessing the significance of the histological type of primary tracheal tumors based on our own data and to review the literature. METHODS We carried out a retrospective analysis of 89 patients with primary tracheal tumors treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between 2000 and 2016. The study assessed patient demographics, tumor characteristics and treatment, with a focus on SCC, ACC, and other histological types. Different histological types were compared in terms of overall survival, disease-free survival, and progression-free survival. RESULTS SCC was the most frequently diagnosed histological type (56.2%), followed by ACC (21.3%). Patients with SCC were typically older (78% over 60 years), predominantly male (66%), and associated with smoking. In contrast, the ACC had a more balanced gender distribution and did not correlate with smoking. ACC displayed a significantly better prognosis, with a median overall survival of 129.4 months, compared with 9.0 months for SCC. CONCLUSION Histological type plays a crucial role in the prognosis of primary tracheal tumors. ACC demonstrated a more favorable outcome compared with SCC.
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Affiliation(s)
- Aleksandra Piórek
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Adam Płużański
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Paweł Teterycz
- Department of Soft Tissue/Bone Sarcoma and MelanomaMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
- Department of Computational OncologyMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Sylwia Tabor
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Kinga Winiarczyk
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Magdalena Knetki‐Wróblewska
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Dariusz M. Kowalski
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Maciej Krzakowski
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
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5
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Montenegro C, Mattavelli D, Lancini D, Paderno A, Marazzi E, Rampinelli V, Tomasoni M, Piazza C. Treatment and outcomes of minor salivary gland cancers of the larynx and trachea: a systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:365-374. [PMID: 37814980 PMCID: PMC10773543 DOI: 10.14639/0392-100x-n2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/10/2023] [Indexed: 10/11/2023]
Abstract
Objectives Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to describe shareable treatment strategies and oncological outcomes of these neoplastic entities. Methods Full text English manuscripts published from January 1st 2000 to December 14th 2022 were included. Data on demographics, treatments and outcomes were collected. A pooled analysis of 5-year overall survival (OS) was performed. Results Seventeen articles and 365 patients met the inclusion criteria. The most common subsites involved were subglottic and distal trachea. Adenoid cystic carcinoma was, by far, the most frequent histotype. The first-choice treatment strategy was surgery (86.8%), while adjuvant treatments were delivered in 57.4% of patients. Only 12.9% were treated with definitive radiotherapy with/without chemotherapy. The mean follow-up was 68.3 months. One hundred nine (34.9%) deaths were recorded and 62.4% were cancer-related. Five-year OS ranged from 20% to 100% and, at pooled analysis, it was 83% (range, 78-87%). Conclusions In case of MiSGC of the larynx and trachea, surgery remains the mainstay of treatment. Adjuvant treatments are frequently delivered. Survival estimates are good overall, but highly heterogeneous.
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Affiliation(s)
- Claudia Montenegro
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Davide Lancini
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Marazzi
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
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6
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Botero JD, Pérez Restrepo M, Murillo MA, Campo F, Correa L. An Unusual Finding of a Neurogenic Tumor of the Trachea: A Tracheal Schwannoma. Cureus 2023; 15:e48172. [PMID: 38046748 PMCID: PMC10693382 DOI: 10.7759/cureus.48172] [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: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
We report a rare case of a 57-year-old female patient with intraluminal tracheal obstruction caused by a benign schwannoma. She underwent successful bronchoscopic resection under general anesthesia, with no complications observed during the post-procedure follow-up. Tracheal schwannomas are exceedingly uncommon, and while conventional treatment involves surgical resection, bronchoscopic techniques, such as laser ablation, can be a valuable alternative, particularly for high-risk patients. Further studies are needed to explore the full potential of bronchoscopic interventions in managing tracheal schwannomas.
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Affiliation(s)
| | | | | | | | - Luis Correa
- Pathology, Clínica Cardio VID, Medellín, COL
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7
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Buchalet C, Durdux C. Role of radiotherapy in the management of rare solid thoracic tumors of the adults. Cancer Radiother 2023; 27:614-621. [PMID: 37558606 DOI: 10.1016/j.canrad.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 08/11/2023]
Abstract
Thoracic tumors include more than one hundred histopathological subtypes. Rare thoracic malignancies can be defined as representing less than 1% of all thoracic tumors. The European Rare Cancer Surveillance Project (RARECARE) identified rarity as an incidence less than 6 for 100,000 people, with significant difference of prevalence between them. Modalities of treatment for these pathologies include surgery, radiotherapy, and systemic therapies. In this article, we aim to discuss role and techniques of radiotherapy in management of rare solid thoracic tumors in adults, focusing on different anatomical locations such as lung parenchyma, mediastinum, vessels, chest wall and pleural cavity.
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Affiliation(s)
- C Buchalet
- Département d'oncologie radiothérapie, Institut du Cancer de Montpellier, 208, avenue des Apothicaires, 34000 Montpellier, France.
| | - C Durdux
- Département d'oncologie radiothérapie, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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8
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Zheng Z, Du Z, Fang Z, Shi Y, Chen X, Jin M, Liu K. Survival benefit of radiotherapy and nomogram for patients with primary tracheal malignant tumors: a propensity score-matched SEER database analysis. J Cancer Res Clin Oncol 2023; 149:9919-9926. [PMID: 37249645 PMCID: PMC10423124 DOI: 10.1007/s00432-023-04896-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/20/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE The purpose of this study was to conduct a matched-pair analysis to assess the impact of radiotherapy (RT) on patients with malignant tracheal tumors using the surveillance, epidemiology, and end results database. Additionally, a predictive nomogram was developed for patients with malignant tracheal tumors. METHODS Propensity score matching (PSM) was used to minimize bias between the RT and no-RT groups. We utilized both univariate and multivariate Cox proportional hazards regression analyses to identify independent prognostic factors for patients and subgroups. We developed a novel nomogram and evaluated its results using the C-index. RESULTS A total of 648 patients between 1975 and 2019 were included, and 160 patients in RT were 1:1 propensity score-matched with no-RT. The independent prognostic factors for patients with tracheal malignant tumors were surgery, marital status, disease extension, pathology, and age. The independent risk factors for patients without surgery included RT and disease extension. The C-index confirmed that the nomogram accurately predicted the prognosis of patients with tracheal malignant tumors. CONCLUSIONS Our findings suggest that RT may provide a survival benefit for tracheal cancer patients who did not undergo surgery. The nomogram can be a useful tool for predicting prognosis in patients with tracheal malignant tumors.
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Affiliation(s)
- Zhen Zheng
- Department of Radiation Oncology and Chemotherapy, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, China
| | - Zhennan Du
- Department of Respiratory Medicine, Ningbo Yinzhou No. 2 Hospital, Ningbo, 315000, China
| | - Zhongjie Fang
- Department of Cardiothoracic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, China
| | - Yunbin Shi
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, China
| | - Xue Chen
- Department of Radiation Oncology and Chemotherapy, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, China
| | - Ming Jin
- Department of Radiation Oncology and Chemotherapy, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, China
| | - Kaitai Liu
- Department of Radiation Oncology and Chemotherapy, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, China.
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9
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Inomata M, Kuroki S, Oguri N, Sato Y, Kawano F, Maeda R. Pleomorphic adenoma of the trachea: A case report. Int J Surg Case Rep 2023; 109:108499. [PMID: 37459695 PMCID: PMC10439302 DOI: 10.1016/j.ijscr.2023.108499] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Although pleomorphic adenoma is the most common type of parotid gland tumor, its occurrence in the trachea is rare. Here, we describe a successfully resected pleomorphic adenoma of the trachea in a woman with severe respiratory failure that had been preoperatively misdiagnosed as asthma. CASE PRESENTATION A 69-year-old woman presented to the emergency department with symptoms of worsening dyspnea and subsequent loss of consciousness. She had a history of progressively worsening wheezing and stridor over the course of 2-years and had been diagnosed with asthma. Arterial blood gas sample analysis indicated type II respiratory failure. A chest computed tomographic scan revealed a tumor in the trachea, which was almost completely obstructing the lower tracheal lumen. The tumor was located just above the carina. To alleviate airway constriction and achieve complete resection, carinal resection with reconstruction was performed. The postoperative diagnosis was pleomorphic adenoma of the trachea. CLINICAL DISCUSSION Pleomorphic adenoma is a rare tracheal tumor that may present with obstructive airway symptoms that mimic asthma. CONCLUSION Tracheal tumors should be considered in patients with chronic respiratory symptoms that do not improve with medication.
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Affiliation(s)
- Mayu Inomata
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Shoei Kuroki
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Nobuyuki Oguri
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Yuichiro Sato
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Fumiya Kawano
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Ryo Maeda
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
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10
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Nilssen Y, Solberg S, Brustugun OT, Møller B, Sundset A, Wahl SGF, Helland Å. Tracheal cancer: a rare and deadly but potentially curable disease that also affects younger people. Eur J Cardiothorac Surg 2023; 64:ezad244. [PMID: 37348858 PMCID: PMC10329490 DOI: 10.1093/ejcts/ezad244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/26/2023] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES The incidence of tracheal cancer is low, few clinicians get much experience and the awareness may be low. Recent data on the treatment and outcome are limited. The aim of the present study was to present updated, national data on the incidence, characteristics, treatment and outcome for patients with tracheal cancer. METHODS All tracheal cancers registered at the Cancer Registry of Norway in 2000-2020 were extracted. The patient and tumour characteristics age, sex, stage, histology and treatment modality (surgery and radiotherapy) were examined. Overall, median and relative survival were estimated. Cox regression models were used to identify independent prognostic factors. RESULTS The 77 patients diagnosed with tracheal cancer equals a crude incidence rate and an age-standardized incidence rate of 0.075 and 0.046 per 100,000 per year respectively. The mean age was 63.8 years (range: 26-94). The numerical preponderance of men (n = 41) is not statistically significant. Eighteen patients (23.4%) were diagnosed in the localized stage. The 5-year overall survival was 31.7% [95% confidence interval (CI): 21.0-42.9], and in those treated with surgical resection or curative radiotherapy, it was 53.7% (95% CI: 26.1-75.0) and 37.8% (95% CI: 18.8-56.7), respectively. Age, histological type and treatment modality were identified as independent prognostic factors. CONCLUSIONS Despite improved survival, the prognosis for patients with tracheal cancer is still poor. Few are diagnosed in the early stage and thus most are not eligible for curative treatment, mainly surgery. An increased awareness and diagnosis in the earlier stage is crucial.
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Affiliation(s)
- Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Steinar Solberg
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
- Department of Cardiothoracic Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Odd Terje Brustugun
- Section of Oncology, Vestre Viken Hospital Trust, Drammen, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bjørn Møller
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Arve Sundset
- Department of Pulmology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Sissel Gyrid Freim Wahl
- Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Åslaug Helland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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11
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Wang B, Zhang Z, Guo Y, Yu F. Trachea repair using an autologous pericardial patch combined with a 3D carbon fiber stent: A case report. Front Surg 2023; 9:1086792. [PMID: 36700013 PMCID: PMC9869265 DOI: 10.3389/fsurg.2022.1086792] [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] [Received: 11/01/2022] [Accepted: 12/05/2022] [Indexed: 01/12/2023] Open
Abstract
This study is the first to use an autologous pericardial patch combined with a 3D carbon fiber stent for the plastic repair of a large trachea defect. Radical surgery is the optimal therapy for primary malignant tracheal tumors. Tracheoplasty or repair is required to guarantee trachea integrity and normal ventilation function after tracheal tumor resection. Here, we present a case of plastic repair of the trachea using an autologous pericardial patch and a 3D custom-made carbon fiber stent. A 4 cm trachea defect was successfully repaired after resecting a malignant schwannoma. The postoperative ventilatory function was normal without obvious symptoms of discomfort. Fiberoptic bronchoscopy showed a smooth mucosal surface of the endotracheal wall and patency of the airway. CT scans performed 3 years after surgery showed no recurrence. Therefore, we can conclude that a 3D carbon fiber stent is feasible for abolishing patch floating and preventing tracheal stenosis.
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Affiliation(s)
- Bin Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Early Diagnosis and Precise Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China,Early-Stage Lung Cancer Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhe Zhang
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Early Diagnosis and Precise Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China,Early-Stage Lung Cancer Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuanwei Guo
- Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fenglei Yu
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Early Diagnosis and Precise Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China,Early-Stage Lung Cancer Center, The Second Xiangya Hospital of Central South University, Changsha, China,Correspondence: Fenglei Yu
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12
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Muacevic A, Adler JR, Komnos ID, Litsou EV, Psychogios GV. Management of an Acute Airway Obstruction Due to Tracheal Carcinoma in a Patient With Severe Glottic Stenosis. Cureus 2023; 15:e33203. [PMID: 36733576 PMCID: PMC9888602 DOI: 10.7759/cureus.33203] [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: 12/31/2022] [Indexed: 01/03/2023] Open
Abstract
In this paper, we present the case of acute airway obstruction due to tracheal carcinoma in a patient with glottic stenosis due to previously treated laryngeal carcinoma. Because of severe dyspnea from the obstructive endotracheal mass, tracheotomy under local anesthesia was immediately performed. Intubation with pediatric size (I.D. 4.5 mm) cuffed endotracheal tube was performed by the surgeon through tracheostomy under endoscopic visualization. Blakesley forceps and electrocautery were used for tumor debulking. Postoperatively there were no complications and the patient was discharged after four days. The histopathology report showed a squamous cell carcinoma. The tumor board decided on adjuvant chemoradiotherapy for the treatment of the patient.
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13
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A Reverse Thymic Fat Pad Flap to Cover the Anastomosis of an Extended Tracheal Resection Following Induction Chemotherapy: A Challenging Case Report. SURGERIES 2022. [DOI: 10.3390/surgeries3030029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to protect the anastomotic suture line. We reported a 67-year-old patient with middle tracheal squamous cell carcinoma treated by induction chemotherapy followed by a successful extended tracheal resection. The anastomosis was covered by a reversed thymic fat pad flap to prevent the erosion of adjacent brachiocephalic vessels. Postoperative concurrent chemoradiation did not threaten the integrity of the suture line. Careful tracheal dissection and accurate release manoeuvres are mandatory to achieve a tension-limited anastomosis. Extended tracheal resection may be safely performed after induction chemotherapy, with excellent long-term outcomes. A thymic fat flap seems to be beneficial to suture-line healing.
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14
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Caramujo C, da Cruz RM, Marques RV, Jesus E. Primary adenoid cystic carcinoma of the trachea: an elusive diagnosis of chronic dyspnoea. BMJ Case Rep 2022; 15:e250227. [PMID: 35944942 PMCID: PMC9367189 DOI: 10.1136/bcr-2022-250227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/03/2022] Open
Abstract
Primary adenoid cystic carcinoma (ACC) of the trachea is a rare entity, with a 5-year survival between 50% and 80% for resectable cases and 30% in case of unresectable disease. We report a case of a primary ACC on a woman in her 70s that presented with a drawn-out history of dyspnoea. She was diagnosed with an unresectable obstructive tumour of the trachea, which required the placement of a Y-shaped stent. The patient underwent concomitant chemoradiotherapy, with partial response, and is still in follow-up, without evidence of disease progression.
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Affiliation(s)
- Cecília Caramujo
- Department of Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Rafael Moiteiro da Cruz
- Department of Pathology, Hospital de Santa Maria, Lisboa, Portugal
- Universidade de Lisboa Faculdade de Medicina, Lisboa, Portugal
| | - Rui Vale Marques
- Department of Radiotherapy, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Emanuel Jesus
- Department of Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
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15
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Li ZH, Dong B, Wu CL, Li SH, Wu B, Sheng YL, Li F, Qi Y. Case Report: ECMO-Assisted Uniportal Thoracoscopic Tracheal Tumor Resection and Tracheoplasty: A New Breakthrough Method. Front Surg 2022; 9:859432. [PMID: 35445074 PMCID: PMC9013741 DOI: 10.3389/fsurg.2022.859432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/24/2022] [Indexed: 11/22/2022] Open
Abstract
Primary tracheal tumors are seldom seen, and most of them are malignant. At present, the main treatment is surgical resection. It is rare to accomplish tracheal tumor resection and tracheoplasty via uniportalal thoracoscopy. In order both to maintain the patient's oxygen supply during surgery and to reduce the size of the surgical incision, we have innovatively integrated the ECMO-assisted and uniportal thoracoscopic techniques for the first time, perfectly achieving tracheal tumor resection and tracheoplasty. The intraoperative manipulation was only 180 min in duration. The patient returned to the intensive care unit and recovered smoothly after the surgery. The patient was discharged from the hospital 17 days after the operation. ECMO-assisted uniportal thoracoscopic tracheal resection and tracheoplasty provides a new idea and method for colleagues.
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16
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Zhao Y, Feng Q. ASO Author Reflections: Surgery With or Without Additional Radiotherapy as a Therapeutic Strategy in ACC of Lobar Bronchial Origin. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11596-z. [PMID: 35353254 DOI: 10.1245/s10434-022-11596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Ying Zhao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Qinfu Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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17
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Zhao Y, He G, Zhai Y, Zhou Z, Bi N, Mao Y, Zhang Y, Xiao Z, Gao S, Lv J, Xue Q, Feng Q. Adenoid Cystic Carcinoma of Lobar Bronchial Origin: 20-Year Experience at a Single Institution. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11590-5. [PMID: 35355128 DOI: 10.1245/s10434-022-11590-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/08/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pulmonary adenoid cystic carcinoma (ACC) is a rare type of lung malignancy. The prevalence of ACC of lobar bronchial origin is lower than that of other lung malignancies, and studies investigating it are lacking. This study aimed to evaluate survival of patients with ACC of the lobar bronchus after surgical resection and to explore its prognostic factors. METHODS Between January 2000 and December 2019, 35 patients at the National Cancer Center/Cancer Hospital with a diagnosis of ACC of the lobar bronchus were included in the retrospective analysis. RESULTS During a median follow-up period of 61 months (range, 10-194 months), the analysis showed a 5-year overall survival (OS) rate of 81.4%, a 5-year locoregional recurrence-free survival rate of 84.0%, and 5-year disease-free survival rate of 60.1%. The univariate analysis exclusively identified the surgical margin as a predictor of OS, and survival was significantly longer for the patients with negative surgical margins than for those with positive surgical margins (R0 vs. R1: 94.4% vs. 66.0%; p = 0.014). Adjuvant radiotherapy was administered to most of the patients with positive surgical margins, which might have contributed to prolonged OS (R0 vs. R1+RT: 94.4% vs. 66.7%, p = 0.173; R0 vs. R1+no RT: 94.4% vs. 62.5%, p = 0.007). CONCLUSIONS For ACC of lobar bronchial origin, complete resection is the radical treatment, and the OS rate was significantly higher for the R0 patients than for the R1 patients. Adjuvant radiotherapy for patients with R1 may prolong survival.
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Affiliation(s)
- Ying Zhao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guosheng He
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yirui Zhai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Zongmei Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nan Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Zhang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zefen Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jima Lv
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinfu Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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18
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Parshin VD, Rusakov MA, Parshin AV, Mirzoyan OS, Vizhigina MA, Simonova MS, Parshin VV, Ursov MA. [Surgery of primary tracheal tumors]. Khirurgiia (Mosk) 2022:12-24. [PMID: 35920218 DOI: 10.17116/hirurgia202208112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the main forms of primary tracheal cancer (PTC), to specify the indications for various surgeries in these patients depending on extent and localization of lesion. MATERIAL AND METHODS There were 263 PTC patients. Benign tumors were diagnosed in 68 (25.9%) patients, malignancies - in 195 (74.1%) cases. Tracheal cancer includes 3 basic morphological variants - adenocystic cancer (49.7%), carcinoid (18.7%) and squamous cell carcinoma (19.0%). Other forms of malignancies were much less common. We applied endoscopic intraluminal and open surgeries. In malignant PTC, open surgeries were performed in 165 (84.6%) out of 195 patients. Baseline palliative endoscopic treatment was performed in 30 patients. They underwent airway recanalization (with subsequent tracheal stenting in 19 patients). Endoscopic resection was preferred for benign tumors. RESULTS Twenty (12.1%) patients died after open surgery, and 1 (3.3%) patient died after endoscopic procedure. Most lethal outcomes occurred in early years of development of tracheal surgery. The causes of mortality were tracheal anastomotic failure in 12 patients, pneumonia in 6 patients, and arterial bleeding in 2 patients. Severe postoperative period was observed in all 3 patients after tracheal replacement with a silicone prosthesis. Long-term treatment outcomes depended on morphological structure of PTC. Favorable results were observed in patients with neuroendocrine tumor (carcinoid), worse outcomes in adenocystic cancer and unfavorable results in squamous cell carcinoma (p<0.0013). Five-year survival rates were 75%, 65.6%, and 13.3%; 10-year survival rates were 75%, 56.2%, and 13.3%, respectively. These outcomes after combined treatment of primary tracheal cancer were significantly better compared to lung cancer (p<0.05 when compared to global data). CONCLUSION Treatment of primary tracheal cancer should be based on classical principles of modern oncology (combined therapy, tumor resection with lymphadenectomy). Open and endoscopic interventions are justified. PTC is characterized by more favorable outcomes compared to lung cancer. It is difficult to analyze long-term results in tracheal cancer depending on various features of tumor process due to small number of observations. Accurate conclusions require multiple-center studies, preferably with international participation, which can convincingly prove certain concept.
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Affiliation(s)
| | - M A Rusakov
- National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia
| | - A V Parshin
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - O S Mirzoyan
- National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia
| | - M A Vizhigina
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - M S Simonova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - V V Parshin
- National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia
| | - M A Ursov
- Sechenov First Moscow State Medical University, Moscow, Russia
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19
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Mohan A, Iyer H, Pahuja S, Barwad A. A rare primary tracheal tumor. Lung India 2022; 39:195-198. [PMID: 35259805 PMCID: PMC9053918 DOI: 10.4103/lungindia.lungindia_972_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A 20-year-old male without any prior comorbidities presented with 6-month history of hemoptysis as the sole symptom. Clinico-radiological profile and bronchoscopy were suggestive of a tracheal mass. This clinico-pathologic conference discusses the differential diagnoses of primary tumors of the trachea and their management options.
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20
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Kovacs AC, Vodanovich D, Mogridge EK, Wun L, Corry J. A case of primary tracheal squamous cell carcinoma arising from malignant transformation of recurrent respiratory papillomatosis, with a complete response to concurrent chemoradiotherapy. SAGE Open Med Case Rep 2021; 9:2050313X211054623. [PMID: 34707869 PMCID: PMC8543711 DOI: 10.1177/2050313x211054623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/05/2021] [Indexed: 11/22/2022] Open
Abstract
Recurrent respiratory papillomatosis is a human papillomavirus-mediated condition characterised by the development of benign squamous papillomata of the respiratory tract. Malignant transformation of recurrent respiratory papillomatosis, while rare, carries a poor prognosis and there are limited data surrounding treatment options, particularly in inoperable disease. We present the case of a 64-year-old male who developed malignant airway obstruction secondary to primary tracheal squamous cell carcinoma in the setting of a 5-year history of recurrent laryngotracheal papillomatosis, requiring placement of tracheostomy while on veno-venous extracorporeal membranous oxygenation. He was managed with cisplatin-based definitive chemoradiotherapy and had a complete metabolic response on post-treatment positron emission tomography/computed tomography, and remains free of recurrent squamous cell carcinoma at 16 months following treatment. This case supports the use of combined chemoradiotherapy as a potential therapeutic option for patients with primary tracheal squamous cell carcinoma, and emphasises the challenges associated with the long-term management of recurrent respiratory papillomatosis.
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Affiliation(s)
- Aaron C Kovacs
- Department of ENT/Head and Neck Surgery, St
Vincent’s Hospital Melbourne, Melbourne, VIC, Australia
| | - Domagoj Vodanovich
- Department of ENT/Head and Neck Surgery, St
Vincent’s Hospital Melbourne, Melbourne, VIC, Australia
| | - Emily K Mogridge
- Department of ENT/Head and Neck Surgery, St
Vincent’s Hospital Melbourne, Melbourne, VIC, Australia
| | - Lisa Wun
- Department of ENT/Head and Neck Surgery, St
Vincent’s Hospital Melbourne, Melbourne, VIC, Australia
| | - June Corry
- GenesisCare Radiotherapy, St Vincent’s
Hospital Melbourne, Melbourne, VIC, Australia
- Department of Medicine, The University of
Melbourne, Melbourne, VIC, Australia
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21
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Brochu V, Tamber GS, Rayes RF, Fiset B, Caglar D, Camilleri-Broët S, Tabah R, Walsh LA, Spicer JD, Fiset PO. High-Grade Neuroendocrine Carcinoma Within a Tracheal Polyp: A Case Report. JTO Clin Res Rep 2021; 2:100169. [PMID: 34590020 PMCID: PMC8474438 DOI: 10.1016/j.jtocrr.2021.100169] [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: 01/21/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Primary carcinomas of the trachea are rare, with a reported annual incidence of one in a million. We present a case of a previously undescribed polypoid high-grade neuroendocrine carcinoma of the trachea. Resection of the carcinoma revealed only superficial invasion of the mucosa and without evidence of local or distant metastatic disease. Histologically, the tumor had high-grade features with necrosis and a high mitotic index. Methods Characterization of this rare neuroendocrine carcinoma of the trachea was performed by immunohistochemistry and whole-genome sequencing. Results Immunohistochemistry result was positive for neuroendocrine markers, p16 and an elevated Ki-67. Whole-genome sequencing of the lesion was performed and revealed a very unusual and very distinct mutational signature without relationship to other relevant neuroendocrine carcinomas. Neither known driver nor targetable mutations were found by whole-genome sequencing. Analysis of the sequence of numerous viral elements of human papillomavirus-18 suggests that the pathogenesis of the lesion is related to viral integration. The patient developed distal recurrence, which progressed to widespread pulmonary dissemination, presumably through aerogenous spread of disease. Conclusions This is the first characterization of this type of tracheal tumor, including genomic findings, pathogenesis, and natural history.
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Affiliation(s)
- Victor Brochu
- Department of Pathology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Gurdip Singh Tamber
- Department of Pathology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Roni F Rayes
- Division of Thoracic Surgery, McGill University Health Center, Montreal, Quebec, Canada.,Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Benoit Fiset
- Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Derin Caglar
- Department of Pathology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sophie Camilleri-Broët
- Department of Pathology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Roger Tabah
- Department of General Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Logan A Walsh
- Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Jonathan D Spicer
- Division of Thoracic Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Pierre Olivier Fiset
- Department of Pathology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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22
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Zeng R, Wang H, Cai X, Guo X, Ping Y, Yang Q. Radiotherapy for Primary Tracheal Carcinoma: Experience at a Single Institution. Technol Cancer Res Treat 2021; 20:15330338211034273. [PMID: 34372715 PMCID: PMC8361538 DOI: 10.1177/15330338211034273] [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] [Indexed: 11/16/2022] Open
Abstract
Background: There is limited understanding of tracheal carcinoma (TC) because of its rarity. We examined the efficacy of radiotherapy (RT) for patients with primary TC. Methods: We analyzed the records of 32 patients with primary TC who received RT at our center between November 1996 and December 2016. Results: Thirteen patients received adjuvant RT and 18 received definitive RT. Eight patients achieved complete remission (CR) after definitive RT. Among all patients, the 5-year overall survival (OS) rate was 46.9% and the locoregional progression free survival (LRPFS) rate was 68.1%. Univariate analysis indicated the 5-year OS was better in those with adenoid cystic adenocarcinoma than squamous cell carcinoma (P = 0.001); the 5-year LRPFS was better in patients who received surgical resection than those who did not (92.9% vs 46.4%, P = 0.013) and in patients who received postoperative RT than in those who received definitive RT (91.7% vs 50.1%, P = 0.038). A sub-group univariate analysis indicated the 5-year PFS was better for those who received at least 68 Gy of radiation (44.4% vs 13.0%, P = 0.044). Patients who achieved CR had a better 5-year PFS than those who did not (57.1% vs 10%, P = 0.006). No patients had a toxicity of grade 3 or more. Conclusions: Adjuvant and definitive RT are safe and effective treatments for TC. Patients who received dosages of 68 Gy or more and who had complete tumor regression following definitive RT seemed to have better long-term survival.
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Affiliation(s)
- Ruifang Zeng
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Ruifang Zeng and Hanyu Wang contribute equally to this work
| | - Hanyu Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China.,Ruifang Zeng and Hanyu Wang contribute equally to this work
| | - Xiaohui Cai
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoqiong Guo
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanan Ping
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiuyuan Yang
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
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23
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Chen L, Campisi A, Wang Z, Dell'Amore A, Ciarrocchi AP, Zhao H, Stella F, Yao F. Left secondary carinal resection and reconstruction for low-grade bronchial malignancies. JTCVS Tech 2021; 8:196-201. [PMID: 34401852 PMCID: PMC8350885 DOI: 10.1016/j.xjtc.2021.05.013] [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: 08/31/2020] [Accepted: 05/13/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives A rare and complex procedure, total lung sparing left secondary carinal resection and reconstruction is only performed in a few specialized centers in a restricted group of patients. We reviewed our experience to evaluate its safety. Methods Patients who underwent left secondary carinal resection and reconstruction with complete lung parenchymal preservation for low-grade bronchial malignancies at the Shanghai Chest Hospital and the Padua University Hospital were retrospectively reviewed. Clinicopathologic factors and perioperative outcomes were analyzed. Results Thirty patients underwent the procedure between July 2012 and July 2019 (mean age, 42.9 years). No operative mortality occurred and postoperative complications developed in 4 patients (13.3%), including pneumonia (n = 3 [10.0%]), subcutaneous emphysema (n = 2 [6.7%]), and prolonged air leak (n = 2 [6.7%]). Pathologies included adenoid cystic carcinoma (n = 11), mucoepidermoid carcinoma (n = 6), carcinoid tumors (n = 9 [8 typical and 1 atypical subtypes]), inflammatory myofibroblastic tumor (n = 3), and myoepithelioma (n = 1). The margins were positive in 8 patients (26.7%), whereas 2 patients (6.7%) had positive lymph nodes. Adjuvant therapies were performed postoperatively, including chemoradiotherapy for positive lymph nodes and radiotherapy for positive margins. Conclusions Total lung sparing left secondary carinal resection and reconstruction can be performed safely in well-selected and oncologically appropriate patients with low-grade bronchial malignancies.
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Affiliation(s)
- Liang Chen
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Alessio Campisi
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Thoracic Surgery Unit, Department of Thoracic Diseases, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Zhexin Wang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Andrea Dell'Amore
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery and Vascular Sciences, Padua University Hospital, University of Padua, Padua, Italy
| | - Angelo Paolo Ciarrocchi
- Thoracic Surgery Unit, Department of Thoracic Diseases, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Heng Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Franco Stella
- Thoracic Surgery Unit, Department of Thoracic Diseases, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Feng Yao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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24
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Behbahani S, Barinsky GL, Wassef D, Paskhover B, Kaye R. Patterns of Care and Outcomes of Primary Adenoid Cystic Carcinoma of the Trachea. Ann Otol Rhinol Laryngol 2021; 131:78-85. [PMID: 33870720 DOI: 10.1177/00034894211008101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Primary tracheal malignancies are relatively rare cancers, representing 0.1% to 0.4% of all malignancies. Adenoid cystic carcinoma (ACC) is the second most common histology of primary tracheal malignancy, after squamous cell carcinoma. This study aims to analyze demographic characteristics and potential influencing factors on survival of tracheal ACC (TACC). METHODS This was a retrospective cohort study utilizing the National Cancer Database (NCDB). The NCDB was queried for all cases of TACC diagnosed from 2004 to 2016 (n = 394). Kaplan-Meier (KM) and Cox proportional-hazards models were used to determine clinicopathological and treatment factors associated with survival outcomes. RESULTS Median age of diagnosis was 56 (IQR: 44.75-66.00). Females were affected slightly more than males (53.8% vs 46.2%). The most prevalent tumor diameter range was 20 to 39 mm (34.8%) followed by greater than 40 mm in diameter (17.8%). Median overall survival (OS) was 9.72 years with a 5- and 10-year OS of 70% and 47.5%, respectively. Localized disease was not associated with a survival benefit over invasive disease (P = .388). The most common intervention was surgery combined with radiation therapy (RT) at 46.2%, followed by surgery alone (16.8%), and standalone RT (8.9%). When adjusting for confounders, surgical resection was independently associated with improved OS (HR 0.461, 95% CI 0.225-0.946). Tumor size greater than 40 mm was independently associated with worse OS (HR 2.808; 95% CI 1.096-7.194). CONCLUSION Our data suggests that surgical resection, possibly in conjunction with radiation therapy, is associated with improved survival, and tumor larger than 40 mm are associated with worse survival.
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Affiliation(s)
- Sara Behbahani
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Gregory L Barinsky
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - David Wassef
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Boris Paskhover
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rachel Kaye
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
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25
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Ran J, Qu G, Chen X, Zhao D. Clinical features, treatment and outcomes in patients with tracheal adenoid cystic carcinoma: a systematic literature review. Radiat Oncol 2021; 16:38. [PMID: 33608038 PMCID: PMC7893857 DOI: 10.1186/s13014-021-01770-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/11/2021] [Indexed: 11/24/2022] Open
Abstract
Background Primary tracheal adenoid cystic carcinoma (TACC) is rare and originates from the minor salivary gland. Biologically, TACC results in delayed presentation, and the therapeutic effects of multimodal treatment differ across individuals. This study aimed to review cases of TACC to identify clinical features, imaging modalities, treatment, and patient outcomes across follow-ups. Methods The PubMed, Web of Science and MEDLINE databases were searched to identify articles reporting cases of TACC. The study variables included in the analysis were patient demographics, biological characteristics, presenting symptoms, imaging modalities, treatments, follow-up times and survival outcomes. Results A total of 76 articles and 1252 cases were included in this review. The most common presenting symptom was dyspnoea (86.0%), followed by cough (58.0%). Surgery alone (40.9%), surgery with postoperative radiotherapy (36.4%) and radiotherapy alone (19.2%) were used most frequently treatments modalities. Of the 1129 cases with disease control and survival data, there was no evidence of disease in 78.7%, local recurrence was reported in 3.8%. Distant metastasis rate was 24.9% of 418 reported cases, lung (44.2%) was the most commonly involved organ. The 5, 10 years survival rate of patients treated with surgery alone and surgery with postoperative radiotherapy were 86.4%, 55.6% and 97.3%, 44.4%, respectively. Conclusion TACC most common presenting symptoms were dyspnoea, cough and shortness of breath. Surgery alone and surgery with postoperative radiotherapy are predominant treatment modalities. Both seems to provide a good result in term of disease control and long-term survival rate in patients with TACC.
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Affiliation(s)
- Juntao Ran
- Department of Radiation Oncology, The First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Guofeng Qu
- Department of Radiation Oncology, The First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Xiaohua Chen
- Department of Radiation Oncology, The First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Da Zhao
- Department of Radiation Oncology, The First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
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Fiorentino A, Gregucci F, Desideri I, Fiore M, Marino L, Errico A, Di Rito A, Borghetti P, Franco P, Greto D, Donato V. Radiation treatment for adult rare cancers: Oldest and newest indication. Crit Rev Oncol Hematol 2021; 159:103228. [PMID: 33508447 DOI: 10.1016/j.critrevonc.2021.103228] [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: 04/08/2020] [Revised: 12/10/2020] [Accepted: 01/16/2021] [Indexed: 11/17/2022] Open
Abstract
AIM Aim of this analysis is to review the role of RT in the management of several rare tumors for adult patients. METHODS Collection data regarding RT and rare tumors was made by Pubmed. RESULTS For mucosal melanomas, RT is prescribed, being associated with lower local recurrence rate. For trachea tumors, RT was used as adjuvant or salvage treatment for unresectable disease. For pNET, RT can be a suitable option for post-surgical or unresectable/borderline. For bronchopulmonary neuroendocrine tumors the role of adjuvant treatments is uncertain. For hepatobiliary and ovarian malignancy, stereotactic body RT (SBRT) is a promising approach. For soft tissue sarcoma, perioperative treatments are indicated, and a growing role of SBRT in oligometastatic disease is recognized. For endocrine tumors, adjuvant RT has demonstrated benefits through reducing recurrence risk. CONCLUSION The radiotherapy is a frequent indication in adult rare cancers; thus the role of Radiation Oncologist must not be neglected.
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Affiliation(s)
- Alba Fiorentino
- Radiation Oncology Department, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Fabiana Gregucci
- Radiation Oncology Department, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy.
| | - Isacco Desideri
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Section of Radiation Oncology, University of Florence, Italy
| | - Michele Fiore
- Radiation Oncology, Campus Bio-Medico University, Rome, Italy
| | - Lorenza Marino
- Radiation Oncology Department, Humanitas Istituto Clinico Catanese, Misterbianco, Catania, Italy
| | - Angelo Errico
- Radiotherapy Oncology Department, R. Dimiccoli Hospital, Barletta, Italy
| | - Alessia Di Rito
- Radiotherapy Oncology Department, IRCCS "Giovanni Paolo II", Bari, Italy
| | - Paolo Borghetti
- Radiation Oncology Department University and Spedali Civili, Brescia, Italy
| | | | - Daniela Greto
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Section of Radiation Oncology, University of Florence, Italy
| | - Vittorio Donato
- Radiation Oncology Department, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
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Primary tracheal microcystic reticular schwannoma - Case report of a rare neurogenic tumor treated by segmental tracheal resection. Int J Surg Case Rep 2021; 79:251-254. [PMID: 33485177 PMCID: PMC7820791 DOI: 10.1016/j.ijscr.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 02/05/2023] Open
Abstract
Knowledge about tracheal tumors is important to avoid misdiagnosis. Awareness of the option of tracheal resection is necessary to avoid suboptimal treatment recommendations. Microcystic reticular schwannoma is a rare variant of a neurogenic tumor and may occur in the trachea. Complete resection should be considered even without clear preoperative tumor histology. Tracheal segmental resection is a safe procedure and treatment of choice for resectable, intra-/transmural tumors causing tracheal obstruction.
Introduction and importance Diagnosis and treatment of rare diseases are challenging because experience and evidence are limited. Primary tracheal tumors have a low prevalence but awareness of these is important to avoid misdiagnoses. We present a first case of a tracheal microcystic reticular schwannoma in which diagnosis and treatment recommendations were revised several times resulting in months of anxious uncertainty for the patient before complete resection and extensive histopathologic examination were performed. Case presentation A 65-year old woman complained about coughing and cervical pain. Tomographies revealed a tumor of the dorsolateral trachea. After repeated biopsies pathologists and tumorboards in different hospitals could not agree on diagnosis or treatment recommendation, so the impatient patient opted for a complete resection for definite treatment. Clinical discussion Neoplasms of the posterior mediastinum are mainly neurogenic. In rare cases they may originate in the trachea and can be difficult to differentiate from other tumor entities if only biopsies are available. Although the preoperative diagnosis was unclear, tracheal resection was performed successfully. The differential diagnoses of soft tissue sarcoma or myoepithelioma were discarded and a benign, microcystic, reticular schwannoma was confirmed by international reference pathologists. Conclusion Microcystic, reticular schwannoma is a rare variant and may occur in the trachea. Diagnosis of such rare neoplasms can be difficult, resulting in delayed or suboptimal treatment. Often biopsies are not sufficient to reach a definite diagnosis. But even without preoperative histology, tracheal resection is a safe and feasible option for definitive treatment with very low recurrence rates.
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Saikawa H, Uesugi N, Sugai T, Maemondo M. Pleomorphic carcinoma of the trachea after chemoradiotherapy for laryngeal cancer. BMJ Case Rep 2020; 13:13/10/e236819. [PMID: 33127699 PMCID: PMC7604805 DOI: 10.1136/bcr-2020-236819] [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] [Indexed: 11/24/2022] Open
Abstract
A 66-year-old male patient who had received chemoradiotherapy (CRT) for laryngeal cancer 2 years ago visited a local doctor complaining of dyspnoea and wheezing. CT scan showed narrowing of the trachea caused by a tumour. We intubated the trachea over the tumour using a bronchoscope. A week later, the truncated tracheal tumour obstructed the tracheal tube, compromising the patient’s breathing. We removed the obstructed tube and inserted a new one. We submitted the tissue from the tube to a pathologist. Histopathological diagnosis was pleomorphic carcinoma, a subtype of sarcomatoid carcinoma. The mechanism of epithelial–mesenchymal transition (EMT) occurring after CRT was detected in the tumour. Because he had undergone CRT for laryngeal cancer, surgery was not indicated, and we started radiation therapy. Sarcomatoid carcinomas including pleomorphic carcinoma of the trachea are extremely rare, with few reported cases, and EMT is associated with this histological type and CRT.
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Affiliation(s)
- Hirotaka Saikawa
- Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Noriyuki Uesugi
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Makoto Maemondo
- Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
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Hu Y, Ren S, Han W, Zhang B, Shu L, Sun Y, Yu F, Liu W. Primary malignant peripheral nerve sheath tumour of the trachea: a case report and literature review. J Cardiothorac Surg 2020; 15:247. [PMID: 32917245 PMCID: PMC7488480 DOI: 10.1186/s13019-020-01285-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Malignant peripheral nerve sheath tumours (MPNSTs) of the trachea are extremely uncommon neoplasms with unknown genetic and clinical profiles. Only individual cases have been reported in the literature to date. Case presentation Here, we present a rare case of a 61-year-old female patient with a primary MPNST of the trachea who complained of irritating cough and progressively increasing breathlessness for 4 weeks. This patient initially underwent intraluminal resection of the mass and was misdiagnosed with clear cell sarcoma. Less than a year later, the mass relapsed, and the obstructive symptoms reappeared and gradually worsened. Debulking of the endotracheal tumour mass was performed once again, and an MPNST was definitively diagnosed. Open sleeve tracheal resection and tracheoplasty were later performed with curative intent. This patient was alive without recurrence at her six-month postoperative follow-up. We also compared the clinical outcomes of previously reported cases of MPNSTs and our case. Conclusions This paper emphasizes that thoracic surgeons should be aware that malignant peripheral nerve sheath tumours of the trachea can be misdiagnosed in clinical practice and must be included in the differential diagnosis of tracheal neoplasms.
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Affiliation(s)
- Yan Hu
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, 410011, China
| | - Siying Ren
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Wei Han
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, 410011, China
| | - Boyou Zhang
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, 410011, China
| | - Lu Shu
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, 410011, China
| | - Yi Sun
- Department of Pathology, Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Fenglei Yu
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, 410011, China
| | - Wenliang Liu
- Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, 410011, China.
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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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31
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Zhai Z, Hu J, You Y, Yang X, Song Z. Tumor with slow-developing and recurring lumps of the external ear with skull base and lung metastasis: A case report. Oncol Lett 2020; 20:1567-1572. [PMID: 32724398 PMCID: PMC7377094 DOI: 10.3892/ol.2020.11724] [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: 09/17/2019] [Accepted: 04/15/2020] [Indexed: 11/06/2022] Open
Abstract
The present case report describes a rare case of recurring lumps on the external ear in a 46-year-old Chinese male with a history of >10 years, who presented with large irregular red lumps on the right temple and with lung and skull base metastasis. The patient had a lesion in the right auricle and experienced recurrence following surgical resection. A thorough systemic evaluation revealed no other obvious abnormalities. The patient was diagnosed with adenoid cystic carcinoma (ACC), a slow-growing form of high-grade adenocarcinoma, and refused any further treatment at the present hospital (The First Affiliated Hospital of Army Medical University). At 2 years post-follow-up, the patient had become more frail but was in good spirits. The present study indicated that ACC is a low-grade and commonly slow-developing malignancy that primarily arises from a salivary gland, with recurring and metastatic characteristics.
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Affiliation(s)
- Zhifang Zhai
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Jie Hu
- Department of Dermatology, The First Affiliated Hospital, Zunyi Medical College, Zunyi, Guizhou 563003, P.R. China
| | - Yi You
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Xichuan Yang
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Zhiqiang Song
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing 400038, P.R. China
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Smeltz AM, Bhatia M, Arora H, Long J, Kumar PA. Anesthesia for Resection and Reconstruction of the Trachea and Carina. J Cardiothorac Vasc Anesth 2020; 34:1902-1913. [DOI: 10.1053/j.jvca.2019.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/11/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022]
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National Utilization of Surgery and Outcomes for Primary Tracheal Cancer in the United States. Ann Thorac Surg 2020; 110:1012-1022. [PMID: 32335015 DOI: 10.1016/j.athoracsur.2020.03.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/04/2020] [Accepted: 03/23/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Tracheal cancer (TC) is a rare disease, and surgical treatment requires a high level of expertise. We sought to determine the treatment patterns and surgical outcomes of TC in the United States. METHODS The National Cancer Database was queried for all cases of primary invasive TC without distant metastatic disease between 2004 and 2015. Primary surgical treatment and outcomes were analyzed. Factors associated with utilization of surgery and overall survival were tested using regression analysis. RESULTS Of 1379 identified TC patients, 338 patients (25%) were treated surgically. Among resected patients, most had adenoid cystic (48%) or squamous cell (28%) carcinoma. Median length of hospital stay after resection was 7 days (interquartile range, 3-8), and 30-day mortality was 1.4%. Most nonsurgically managed patients underwent radiation (63%). Factors associated with surgical resection were younger age, higher education level, tumor size, and adenoid cystic histology. On multivariate analysis patients were also more likely to undergo surgery if they traveled a farther distance for treatment (>45 km; odds ratio, 1.53; 95% confidence interval, 1.09-2.13) or were treated at academic centers (odds ratio, 1.68; 95% confidence interval, 1.25-2.26). Five-year overall survival was 71% after resection, 39% after surgical debulking, and 31% without surgery (P < .001). CONCLUSIONS National surgical outcomes for resection of TC demonstrate low perioperative mortality and excellent long-term prognosis. However, few nonmetastatic TC patients underwent surgery, indicating disparities in access to optimal surgical care and variability in practice patterns at a national level.
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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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36
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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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Hararah MK, Stokes WA, Oweida A, Patil T, Amini A, Goddard J, Bowles DW, Karam SD. Epidemiology and treatment trends for primary tracheal squamous cell carcinoma. Laryngoscope 2019; 130:405-412. [PMID: 30977524 DOI: 10.1002/lary.27994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/25/2019] [Accepted: 03/20/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Management of tracheal squamous cell carcinoma (TSCC) has been complicated by the lack of prognostic data and staging. We describe the epidemiology of TSCC and current treatment approaches. METHODS Five hundred thirty-two adult patients with primary TSCC from 2004 to 2012 in the National Cancer Database were identified. Demographic, clinical factors, and 5-year overall survival were analyzed. Staging was classified as localized, regional extension, and distant spread. Treatment modality was defined as "no treatment (NT)," "limited surgery (LS)," "curative surgery (CS)," "LS with any adjuvant therapy (AT) (LS+AT)," "CS with AT (CS+AT)," "radiation therapy (RT)," or "chemoradiation (CRT)." RESULTS Overall survival was 25%. Majority of cases were males, white, and occurred in sixth/seventh decades. Twenty-six percent of cases received CRT, 20% underwent LS+AT or CS+AT, 20% underwent LS or CS only, and 17% underwent RT alone. On multivariate analysis, CS (HR 0.42, 95% CI: 0.26-0.69), CS+AT (HR 0.44, 95% CI: 0.36-0.77), CRT (HR 0.48, 95% CI: 0.35-0.67), and RT (HR, 0.66 95% CI: 0.46-0.94) were associated with decreased likelihood of death compared to NT. Elderly patients and those with poor performance status had worse outcomes even on multivariate analysis. CONCLUSIONS TSCC is increasingly treated with surgery and systemic therapy in addition to RT, with improved survival outcomes. CS, CS+AT, CRT, or RT provided improved survival advantage in patients with variable levels of improvement based on the extent of the disease. Prospective trials would help differentiate survival advantages between treatment modalities. Patients' goals of care, comorbidities, and age should be considered when deciding appropriate treatment recommendations. LEVEL OF EVIDENCE NA Laryngoscope, 130:405-412, 2020.
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Affiliation(s)
- Mohammad K Hararah
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, U.S.A
| | - William A Stokes
- Department of Radiation Oncology, Emory University, Atlanta, Georgia, U.S.A
| | - Ayman Oweida
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, U.S.A
| | - Tejas Patil
- Department of Medical Oncology, University of Colorado School of Medicine, Aurora, U.S.A
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Cancer Center, Duarte, California, U.S.A
| | - Julie Goddard
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, U.S.A
| | - Daniel W Bowles
- Department of Medical Oncology, University of Colorado School of Medicine, Aurora, U.S.A.,Eastern Colorado Health Care System, Department of Veterans Affairs, Denver, Colorado, U.S.A
| | - Sana D Karam
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, U.S.A
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Bedayat A, Yang E, Ghandili S, Galera P, Chalian H, Ansari-Gilani K, Guo HH. Tracheobronchial Tumors: Radiologic-Pathologic Correlation of Tumors and Mimics. Curr Probl Diagn Radiol 2019; 49:275-284. [PMID: 31076268 PMCID: PMC7115773 DOI: 10.1067/j.cpradiol.2019.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/19/2019] [Accepted: 04/02/2019] [Indexed: 12/26/2022]
Abstract
Tracheobronchial masses encompass a broad spectrum of entities, ranging from benign and malignant neoplasms to infectious and inflammatory processes. This article reviews the cross-sectional findings of tracheal tumors and tumor-like entities, correlates imaging findings with histologic pathology, and discusses pearls and pitfalls in accurately diagnosing and classifying tracheal tumors and mimics.
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Affiliation(s)
- Arash Bedayat
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA.
| | - Eric Yang
- Department of Pathology, Stanford University Medical center, Stanford, CA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Saeed Ghandili
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Pallavi Galera
- Department of Pathology, University of Massachusetts Medical School, Worcester, MA, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Hamid Chalian
- Department of Radiology, Duke University, Durham, NC, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
| | - Kianoush Ansari-Gilani
- Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Heiwei Henry Guo
- Department of Radiology, Duke University, Durham, NC, USA; Department of diagnostic Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Radiology, Stanford University Medical center, Stanford, CA
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Chowdhary RL, Chufal KS, Pahuja AK, Bhushan M, Singh R, Ahmad I. Image-guided volumetric modulated arc therapy (IG-VMAT) for unresectable ACC of the trachea: a feasible curative option. BMJ Case Rep 2019; 12:12/3/e227128. [PMID: 30902839 DOI: 10.1136/bcr-2018-227128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A middle-aged man presented with progressively worsening breathlessness and non-productive cough for the last 3 months. On examination, his breathing was stridulous and air entry was decreased bilaterally. He underwent emergency fibre-optic bronchoscopy, which revealed a tracheal growth causing luminal narrowing, and after tumour debulking, he improved symptomatically. Histopathological evaluation of the specimen revealed an adenoid cystic carcinoma of the trachea, and systemic evaluation revealed metastatic dissemination. Systemic molecular-targeted therapy was initiated (gefitinib and later imatinib mesylate) and continued for 5 years, in view of stable disease on periodic follow-up. He subsequently presented with breathlessness again, which was managed with an emergency tracheostomy. In view of stable systemic disease and local progression only, he received definitive radiotherapy with image-guided volumetric modulated arc therapy, which resulted in a complete radiological response. The patient has been disease-free for the last 9 months.
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Affiliation(s)
- Rahul Lal Chowdhary
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Kundan Singh Chufal
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Anjali Kakria Pahuja
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Manindra Bhushan
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Rajpal Singh
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
| | - Irfan Ahmad
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi, India
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Gao H, He X, Du J, Yang S, Wang Y, Zhang J, Zhao C. Competing risk analysis of primary tracheal carcinoma based on SEER database. Cancer Manag Res 2019; 11:1059-1065. [PMID: 30774433 PMCID: PMC6353024 DOI: 10.2147/cmar.s190124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose To analyze the prognostic factors of primary tracheal carcinoma. Patients and methods All patients of primary tracheal carcinoma were extracted from the Surveillance, Epidemiology, and End Results database during 1973-2015. The potential prognostic factors were analyzed by using the competing risk analysis of R statistical software. Results A total of 485 eligible patients were enrolled. The univariate analysis indicated that age, sex, diagnostic confirmation, extension, lymph node, metastasis, multiple primary tumors, primary site surgery, and lymph node dissection were statistically significant for the patients' death due to tracheal tumor. The multivariate analysis indicated that age (P=0.0000, CI: 1.0255-1.0630), lymph node (P=0.0000, CI: 1.6031-3.4890), metastasis (P=0.0100, CI: 1.1342-2.5790), multiple primary tumors (P=0.0000, CI: 0.0276-0.1090), and primary site surgery (P=0.0001, CI: 0.3565-0.7110) were independent prognostic factors affecting survival, and there were significant differences in the stratification of each prognostic factors. Conclusion Age, lymph node, metastasis, multiple primary tumors, and primary site surgery were independent prognostic factors of primary tracheal carcinoma.
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Affiliation(s)
- HongXiang Gao
- Department of Oncology, Chang'An Hospital, Xi'an, Shaanxi, China,
| | - Xuan He
- Department of Oncology, Chang'An Hospital, Xi'an, Shaanxi, China,
| | - JianFei Du
- Department of Oncology, Chang'An Hospital, Xi'an, Shaanxi, China,
| | - SanHu Yang
- Department of Thoracic Surgery, Tangdu Hospital, Xi'an, Shaanxi, China
| | - Yang Wang
- Department of Oncology, Chang'An Hospital, Xi'an, Shaanxi, China,
| | - JunWei Zhang
- Department of Oncology, Chang'An Hospital, Xi'an, Shaanxi, China,
| | - ChenNian Zhao
- Department of Oncology, Chang'An Hospital, Xi'an, Shaanxi, China,
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Wen J, Liu D, Xu X, Chen D, Chen Y, Sun L, Chen J, Fan M. Nomograms for predicting survival outcomes in patients with primary tracheal tumors: a large population-based analysis. Cancer Manag Res 2018; 10:6843-6856. [PMID: 30588090 PMCID: PMC6294060 DOI: 10.2147/cmar.s186546] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The aim of this study was to develop and validate reliable nomograms to predict individual overall survival (OS) and cancer-specific survival (CSS) for patients with primary tracheal tumors and further estimate the role of postoperative radiotherapy (PORT) for these entities. Patients and methods A total of 405 eligible patients diagnosed between 1988 and 2015 were selected from the Surveillance, Epidemiology, and End Results database. All of them were randomly divided into training (n=303) and validation (n=102) sets. For the purpose of establishing nomograms, the Akaike information criterion was employed to select significant prognostic factors in multivariate Cox regression models. Both internal and external validations of the nomograms were evaluated by Harrell’s concordance index (C-index) and calibration plots. Propensity score matching (PSM) method was performed to reduce the influence of selection bias between the PORT group and the non-PORT group. Results Two nomograms shared common variables including age at diagnosis, histology, N and M stages, tumor size, and treatment types, while gender was only incorporated in the CSS nomogram. The C-indices of OS and CSS nomograms were 0.817 and 0.813, displaying considerable predictive accuracy. The calibration curves indicated consistency between the nomograms and the actual observations. When the nomograms were applied to the validation set, the results remained reconcilable. Moreover, the nomograms showed superiority over the Bhattacharyya’s staging system with regard to the C-indices. After PSM, PORT was not associated with significantly better OS or CSS. Only squamous cell carcinoma (SCC) patients in the PORT group had improved OS compared to non-PORT group. Conclusion The first two nomograms for predicting survival in patients with primary tracheal tumors were proposed in the present study. PORT seems to improve the prognosis of SCC patients, which needs further exploration.
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Affiliation(s)
- Junmiao Wen
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China,
| | - Di Liu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China,
| | - Xinyan Xu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China,
| | - Donglai Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, People's Republic of China
| | - Yongbing Chen
- Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou 215000, People's Republic of China
| | - Liang Sun
- School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou 215123, People's Republic of China
| | - Jiayan Chen
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China,
| | - Min Fan
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China,
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Kar P, Malempati AR, Durga P, Gopinath R. Institution of cardiopulmonary bypass in an awake patient for resection of tracheal tumor causing near total luminal obstruction. J Anaesthesiol Clin Pharmacol 2018; 34:409-411. [PMID: 30386033 PMCID: PMC6194819 DOI: 10.4103/joacp.joacp_352_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Prachi Kar
- Department of Anesthesia and Intensive Care, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Amaresh Rao Malempati
- Department of CTVS, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Padmaja Durga
- Department of Anesthesia and Intensive Care, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Ramachandran Gopinath
- Department of Anesthesia and Intensive Care, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
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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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Miura A, Mori T, Yoshida A, Watanabe Y, Sunami K, Watanabe S, Kohno T, Tsuta K. Primary adenocarcinoma of the trachea revealing a mucinous bronchial gland cell origin. Pathol Res Pract 2018; 214:796-799. [DOI: 10.1016/j.prp.2018.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/28/2018] [Accepted: 03/02/2018] [Indexed: 10/17/2022]
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Pathology of Primary Tracheobronchial Malignancies Other than Adenoid Cystic Carcinomas. Thorac Surg Clin 2018; 28:149-154. [DOI: 10.1016/j.thorsurg.2018.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Shafiee S, Adno A, French B, Johansson C, Frankel A, Williamson JP. Central airway obstruction caused by adenoid cystic carcinoma in pregnancy: a case report and review of the literature. Respirol Case Rep 2018; 6:e00317. [PMID: 29721318 PMCID: PMC5909374 DOI: 10.1002/rcr2.317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/24/2018] [Accepted: 02/26/2018] [Indexed: 12/19/2022] Open
Abstract
Malignancy complicates one in a thousand pregnancies. The most frequently diagnosed of these are breast, cervical, melanoma, ovarian, and haematological neoplasms. Tumours of respiratory origin are very uncommon during pregnancy. We present a case of tracheal adenoid cystic carcinoma (ACC), a rare type of primary airway tumour, diagnosed in a pregnant woman. To our knowledge, this is the third reported case of tracheal ACC complicating pregnancy. We discuss potential barriers to timely diagnosis of malignancies during pregnancy and consider optimal management strategies, taking into account the potential harm to the mother and foetus in a field with a limited evidence base.
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Affiliation(s)
- Samaneh Shafiee
- Department of Obstetrics and Gynaecology Liverpool Hospital Sydney Australia
| | - Alan Adno
- Department of Obstetrics and Gynaecology Liverpool Hospital Sydney Australia
| | - Bruce French
- Department of Thoracic Surgery Liverpool Hospital Sydney Australia
| | - Cherynne Johansson
- Department of Obstetrics and Gynaecology Liverpool Hospital Sydney Australia
| | - Anthony Frankel
- Department of Respiratory Medicine Bankstown- Lidcome Hospital Sydney Australia
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Egan M, Redmond KC. High‐flow apnoeic oxygenation delivered by LMA or tracheal tube for tracheal resection and reconstruction surgery. ACTA ACUST UNITED AC 2018. [DOI: 10.21466/ac.haodblo.2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Michael Egan
- Consultant, AnaesthesiaBeacon HospitalDublinIreland
| | - Karen C. Redmond
- ConsultantThoracic and Lung Transplant Surgery, Mater Misericordiae Universty Hospital and Beacon HospitalDublinIreland
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Abstract
Malignant airway tumors present particular challenges for surgeons, namely: to distinguish symptoms from those of the more frequent benign airway diseases; to separate metastatic disease from the uncommon primary tumors; and to consider curative resection in appropriate candidates. Here, we present a critical review of tracheal malignant obstruction, focusing on the evaluation of a patient with malignant airway tumor, patient selection for resection and the predictors of long-term survival. The new development in primary tracheal tumors is an old story, that of making physicians aware that resection rates in epidemiologic studies remain low, mainly because opportunities for resection are missed.
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Affiliation(s)
- Maria Lucia L Madariaga
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Henning A Gaissert
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
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Marital status is an independent prognostic factor for tracheal cancer patients: an analysis of the SEER database. Oncotarget 2018; 7:77152-77162. [PMID: 27780931 PMCID: PMC5363576 DOI: 10.18632/oncotarget.12809] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Although marital status is an independent prognostic factor in many cancers, its prognostic impact on tracheal cancer has not yet been determined. The goal of this study was to examine the relationship between marital status and survival in patients with tracheal cancer. RESULTS Compared with unmarried patients (42.67%), married patients (57.33%) had better 5-year OS (25.64% vs. 35.89%, p = 0.009) and 5-year TCSS (44.58% vs. 58.75%, p = 0.004). Results of multivariate analysis indicated that marital status is an independent prognostic factor, with married patients showing better OS (hazard ratio [HR] = 0.78, 95% confidence interval [CI] 0.64-0.95, p = 0.015) and TCSS (HR = 0.70, 95% CI 0.54-0.91, p = 0.008). In addition, subgroup analysis suggested that marital status plays a more important role in the TCSS of patients with non-low-grade malignant tumors (HR = 0.71, 95% CI 0.53-0.93, p = 0.015). METHODS We extracted 600 cases from the Surveillance, Epidemiology, and End Results (SEER) database. Variables were compared by Pearson chi-squared test, t-test, log-rank test, and multivariate Cox regression analysis. Overall survival (OS) and tracheal cancer-specific survival (TCSS) were compared between subgroups with different pathologic features and tumor stages. CONCLUSIONS Marital status is an independent prognostic factor for survival in patients with tracheal cancer. For that reason, additional social support may be needed for unmarried patients, especially those with non-low-grade malignant tumors.
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