1
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Sezen CB, Yaran OV, Metin M. Carinal sleeve resections. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2023; 31:S8-S20. [PMID: 38344121 PMCID: PMC10852207 DOI: 10.5606/tgkdc.dergisi.2023.24517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/02/2023] [Indexed: 02/21/2024]
Abstract
Carinal resections are frequently performed for carinal tumors. Resection of the carina due to distal tracheal tumors may be required, and the extension of main bronchial tumors to the carina may lead to carinal resection. This is one of the rarely performed operations in thoracic surgery, which is technically challenging and has a high complication rate. In the early series, perioperative mortality rate was reported as 29% and the five-year survival rate as 15%. Due to its technical difficulties and high complication rates, it is performed only in certain centers. In this review, we discuss techniques related to carinal sleeve resection and prognostic factors in the light of literature data.
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Affiliation(s)
- Celal Bugra Sezen
- Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Türkiye
| | - Onur Volkan Yaran
- Department of Thoracic Surgery, Bayburt State Hospital, Bayburt, Türkiye
| | - Muzaffer Metin
- Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Türkiye
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2
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Ke M, Zeng J, Chen Z, Huang R, Wu X, Chu S. Stent loaded with radioactive Iodine-125 seeds for adenoid cystic carcinoma of central airway: A case report of innovative brachytherapy. Front Oncol 2023; 13:837394. [PMID: 37056329 PMCID: PMC10086341 DOI: 10.3389/fonc.2023.837394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) of central airway is very rare. More than half of ACCs are unresectable for tumor extension. There’s rare report on local ACCs only in central airway. We present a case of ACC in central airway who underwent an innovative brachytherapy. A 44-year-old woman was diagnosed with primary ACC in central airway without regional lymphadenopathy or metastatic disease. Stenosis was observed in lower trachea and both left and right main bronchi (stenosis in lumen ≥50%) with bronchoscopy. The tumor was unresectable due to local extension. A Y-shaped and stainless-steel stent loaded with radioactive 125I seeds was placed in the central airway using bronchoscope. The number and distribution of 125I seeds were planed using treatment planning system. The stent was removed three months later. The patient tolerated the procedure well. She was alive without relapse three years after removing the stent with 125I seeds. This case demonstrates the successful use of stent with radioactive 125I seeds for unresectable ACCs in central airway. In the procedure, the stent was placed with bronchoscope and under the vision from bronchoscope. This innovative brachytherapy is well-tolerated, safe, precise and individualized designed. The patient with unresectable ACCs could get a long-term relapse-free survival. Clinical trials could be taken to validate its effectiveness and tolerability in patients with ACCs of central airway.
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Affiliation(s)
- Mingyao Ke
- Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Junli Zeng
- Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Zhide Chen
- Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Rui Huang
- Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Xuemei Wu
- Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
- *Correspondence: Xuemei Wu, ; Shuyuan Chu,
| | - Shuyuan Chu
- Laboratory of Respiratory Disease, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
- *Correspondence: Xuemei Wu, ; Shuyuan Chu,
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3
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Shen YS, Tian XD, Pan Y, Li H. Treatment of primary tracheal schwannoma with endoscopic resection: A case report. World J Clin Cases 2022; 10:10279-10285. [PMID: 36246804 PMCID: PMC9561569 DOI: 10.12998/wjcc.v10.i28.10279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/21/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Schwannoma is a benign tumor originating from the peripheral nerve sheath. The clinical symptoms of tracheal schwannoma depend on the location of the tumor, and the most common clinical symptoms are cough and hemoptysis. The most effective treatment for benign tumors is complete resection of the primary lesion at an early stage. Our experience has demonstrated that primary tracheal schwannoma can be safely excised with a high-frequency electric knife in a minimally invasive manner.
CASE SUMMARY We report a 61-year-old asymptomatic woman who underwent chest computed tomography (CT), which accidentally found an intraluminal tracheal mass without enlarged lymph nodes. Then, the patient underwent bronchoscopy, which found that the tracheal mass originated from the left wall of the upper trachea, was less than 1.5 cm in size, immovable, smooth and 4 cm away from the vocal cord, resulting in partial upper respiratory tract obstruction. Treatment was performed using an endoscopic resection for en bloc removal of the tracheal mass. The diagnosis was primary tracheal schwannoma. A follow-up was performed after endoscopic surgery, and bronchoscopy and thoracic CT were used to monitor whether there was a recurrence. At present, there is no evidence of recurrence, and the patient had a good quality of life. Endoscopic resection may be effective and safe in the treatment of primary tracheal schwannoma.
CONCLUSION Primary tracheal schwannoma is a very rare benign tumor. In this case, we cured it by complete endoscopic resection.
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Affiliation(s)
- Yong-Shuai Shen
- Department of Endoscopy, Tianjin Cancer Hospital Airport Hospital, Tianjin 300000, China
| | - Xiang-Dong Tian
- Department of Endoscopy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Yi Pan
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Hua Li
- Department of Endoscopy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
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4
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Uppal DK, Madan R, Peters NJ, Bal A, Ballari N, Goyal S, Khosla D. Mucoepidermoid carcinoma of the trachea in a 9-year-old male child: case report and review of literature. Radiat Oncol J 2022; 40:208-212. [PMID: 36200310 PMCID: PMC9535415 DOI: 10.3857/roj.2021.00500] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/01/2021] [Indexed: 11/27/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is the most common malignancy of minor salivary glands in adults. Pulmonary MEC is extremely uncommon, comprising only 0.1–0.2% of the primary lung malignancies and <1% of primary bronchial tumors. It is even rarer in children, and literature is limited to a few case reports only. Here we present a case report of a 9-year-old boy diagnosed with primary MEC of the trachea along with a review of the literature. A 9-year-old male child presented with complaint of dry cough for two years which was later associated with shortness of breath after one year. Bronchoscopic examination revealed a growth arising from right lateral wall of carina occluding 50% of the lumen and detailed histopathological examination revealed it to be a MEC of the trachea. The patient underwent local excision of the tumor with primary anastomosis. Because of positive margin, adjuvant radiotherapy of 60 Gy in 30 fractions was given to the tumor bed. The patient tolerated the treatment well and is disease free at 6 months follow-up. Experience with MEC of the trachea in children is limited, and optimal treatment protocols have not been defined, with current treatment mainly extrapolated from MEC of the salivary glands.
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Affiliation(s)
- Deepak Kumar Uppal
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Renu Madan
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
- Correspondence: Renu Madan Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. Tel: +91-172-2756390 Fax: +91-172-2744401, 2745078 E-mail:
| | - Nitin J. Peters
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Amanjit Bal
- Department of Histopathology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Nagarjun Ballari
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Shikha Goyal
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Divya Khosla
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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5
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Assaad M, El Gharib K, Kassem A, Rabah H, El-Sayegh D. Endobronchial Chondroma: A Rare Case of Benign Tumor With Atypical High Standardized Uptake Value. Cureus 2022; 14:e24800. [PMID: 35686284 PMCID: PMC9170439 DOI: 10.7759/cureus.24800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/05/2022] Open
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6
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Singh H, Benn BS, Jani C, Abdalla M, Kurman JS. Photodynamic therapy for treatment of recurrent adenocarcinoma of the lung with tracheal oligometastasis. Respir Med Case Rep 2022; 37:101620. [PMID: 35330589 PMCID: PMC8938912 DOI: 10.1016/j.rmcr.2022.101620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/06/2022] [Accepted: 02/22/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Harpreet Singh
- Department of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
- Corresponding author. Medical College of Wisconsin, 8701 W Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Bryan S. Benn
- Department of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Chinmay Jani
- Department of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mohammed Abdalla
- Department of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jonathan S. Kurman
- Department of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
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7
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Ryu KM, Myong N, Kim D. Endobronchial enchondroma: Unusual bronchial tumor. Clin Case Rep 2022; 10:e05292. [PMID: 35070307 PMCID: PMC8762553 DOI: 10.1002/ccr3.5292] [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: 09/30/2021] [Revised: 11/23/2021] [Accepted: 12/11/2021] [Indexed: 11/20/2022] Open
Abstract
Bronchial chondromas are very rare pulmonary benign tumors. Despite their rarity, clinicians should be aware of the possibility of endobronchial tumors in patients with unexplained respiratory symptoms. Treatment modalities for the complete excision of the tumor should be initiated to prevent further complications based on the individual tumor situation.
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Affiliation(s)
- Kyoung Min Ryu
- Department of Thoracic and Cardiovascular SurgeryDankook University HospitalDankook University College of MedicineCheonanSouth Korea
| | - Na‐Hye Myong
- Department of PathologyDankook University HospitalDankook University College of MedicineCheonanSouth Korea
| | - Dohhyung Kim
- Division of Pulmonary Medicine and AllergyDepartment of Internal MedicineDankook University HospitalDankook University College of MedicineCheonanSouth Korea
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8
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Chen J, Mao J, Ma N, Wu KL, Lu J, Jiang GL. Definitive carbon ion radiotherapy for tracheobronchial adenoid cystic carcinoma: a preliminary report. BMC Cancer 2021; 21:734. [PMID: 34174854 PMCID: PMC8236132 DOI: 10.1186/s12885-021-08493-1] [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: 02/01/2021] [Accepted: 06/07/2021] [Indexed: 12/25/2022] Open
Abstract
Background Tracheobronchial adenoid cystic carcinoma (TACC) is a rare tumour. About one-third of patients miss their chance of surgery or complete resection as it is mostly detected in the advanced stage; hence, photon radiotherapy (RT) is used. However, the outcomes of photon RT remain unsatisfactory. Carbon ion radiotherapy (CIRT) is thought to improve the therapeutic gain ratio; however, the outcomes of CIRT in TACC are unclear. Therefore, we aimed to assess the effects and toxicities of CIRT in patients with TACC. Methods The inclusion criteria were as follows: 1) age 18–80 years; 2) Eastern Cooperative Oncology Group Performance Status 0–2; 3) histologically confirmed TACC; 4) stage III–IV disease; 5) visible primary tumour; and 6) no previous RT history. The planned prescription doses of CIRT were 66–72.6 GyE/22–23 fractions. The rates of overall survival (OS), local control (LC), and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Treatment-induced toxicities and tumour response were scored according to the Common Terminology Criteria for Adverse Events and Response Evaluation Criteria in Solid Tumors, respectively. Results Eighteen patients with a median age of 48 (range 30–73) years were enrolled. The median follow-up time was 20.7 (range 5.8–44.1) months. The overall response rate was 88.2%. Five patients developed lung metastasis after 12.2–41.0 months and one of them experienced local recurrence at 31.9 months after CIRT. The rates of 2-year OS, LC, and PFS were 100, 100, and 61.4%, respectively. Except for one patient who experienced grade 4 tracheal stenosis, which was relieved after stent implantation, no other ≥3 grade toxicities were observed. Conclusions CIRT might be safe and effective in the management of TACC based on a short observation period. Further studies with more cases and longer observation are warranted.
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Affiliation(s)
- Jian Chen
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, 201321, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China
| | - Jingfang Mao
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China. .,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201321, China.
| | - Ningyi Ma
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, 201321, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China
| | - Kai-Liang Wu
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201321, China
| | - Jiade Lu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, 201321, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China
| | - Guo-Liang Jiang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201321, China
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9
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Yang H, Yin J, Tang X, Li G, Li H, Zhao S. Clinical significance of interventional therapeutic bronchoscopy combined with bronchial arterial embolization in the treatment of hypervascular primary airway tumors in children. Pediatr Investig 2021; 5:130-135. [PMID: 34179710 PMCID: PMC8212720 DOI: 10.1002/ped4.12256] [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: 08/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Pediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults. OBJECTIVE To evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors. METHODS We retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children's Hospital. RESULTS Two patients were low-grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5-12 months, and one low-grade bronchial mucoepidermoid carcinoma recurred. INTERPRETATION Interventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration.
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Affiliation(s)
- Haiming Yang
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jie Yin
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xiaolei Tang
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Gan Li
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Huimin Li
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Shunying Zhao
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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10
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Dracham C, Khosla D, Kapoor R, Dey T, Periasamy K, Elangovan A, Madan R, Goyal S, Kumar N. Expanding role of radiotherapy in adenoid cystic carcinoma of the tracheobronchial tree: a new horizon. TUMORI JOURNAL 2021; 108:347-356. [PMID: 33977780 DOI: 10.1177/03008916211012461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Primary adenoid cystic carcinomas (ACCs) of central trachea-bronchi system are rare and heterogeneous tumors. Definitive radiotherapy (RT) is the recommended treatment in surgically unresectable or incomplete resection or in the presence of severe comorbidities. OBJECTIVE To evaluate the clinical features and outcomes of patients with ACC of trachea-bronchi treated with radiotherapy. METHODS Retrospective medical records review was done in all patients with histologically confirmed ACC of trachea-bronchi between January 2010 and December 2019. Patient disease and treatment characteristics and toxicity data were analyzed. Overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were computed using Kaplan-Meier method (log-rank test). RESULTS Nineteen patients (10 women and 9 men) were included in this analysis with median age of 40 years (range, 14-70). Of these patients, 63.2% (n = 12) presented in stage IV disease. Twelve and three patients received definitive (median dose 67.8 Gy) and adjuvant (median dose 50 Gy) RT, respectively. The median follow-up was 42.5 months (range, 4-120); 15 patients were alive and 4 were dead at that time. Local recurrence or progression was observed in 52.6% and distant metastasis found in 47.3% of patients. The 5-year OS, LRFS, and DMFS for all patients were 81.2%, 52.8%, and 39.6%, respectively. Baseline lymph node involvement showed significant impact on OS (56.3% vs 100%, p = 0.011). Among patients receiving definitive RT, patients with higher RT dose (⩾66 Gy) had significantly better survival outcomes (5-year LRFS: 75% vs 16.7%, p = 0.013). CONCLUSION Definitive RT is an exemplary treatment for unresectable disease. Higher dose is recommended to improve long-term outcomes.
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Affiliation(s)
- ChinnaBabu Dracham
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Divya Khosla
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rakesh Kapoor
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Treshita Dey
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kannan Periasamy
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Arun Elangovan
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Renu Madan
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Shikha Goyal
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Narendra Kumar
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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11
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Meirovitz A, Shouchane-Blum K, Maly A, Bersudski E, Hirshoren N, Abrams R, Popovtzer A, Orevi M, Weinberger J. The potential of somatostatin receptor 2 as a novel therapeutic target in salivary gland malignant tumors. J Cancer Res Clin Oncol 2021; 147:1335-1340. [PMID: 33598797 DOI: 10.1007/s00432-021-03538-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment regimens for patients with metastatic or recurrent post-radiation, locoregional, unresectable salivary cancer are limited. An inverse correlation between somatostatin receptor 2 (SSTR2) and the proliferating marker Ki-67 in neuroendocrine tumors has enabled a treatment plan for metastatic disease, utilizing peptide receptor radionuclide therapy. Interestingly, healthy salivary glands express high levels of SSTR2. In this study, the presence of SSTR2, its correlation with Ki-67 in glandular salivary carcinomas and the clinical applicability thereof was determined. METHODS In the retrospective part of this study, 76 adequate tumor tissue specimens obtained from patients diagnosed with primary or metastatic salivary carcinomas between 1988 and 2016, were collected for tissue array and histologically classified. Immunohistochemistry was performed to determine the presence, relative expression and potential correlation of SSTR2 and Ki-67. The clinical significance of SSTR2 expression was determined by prospectively assessing 68Ga-DOTATATE uptake using PET-CT imaging, in patients diagnosed with metastatic salivary gland malignant tumors between 2015 and 2016. RESULTS Sixty-three primary cancer tumors and 14 metastatic tumors were tested. All tumor subtypes were found to express SSTR2 to some extent. The highest expression was seen in Mucoepidermoid carcinoma (MEC) tissues where the majority of specimens (86.4%) expressed SSTR2. A relatively strong immunohistochemical staining score for SSTR2 was observed in MEC, adenoid cystic carcinoma and polymorphous adenocarcinoma. Interestingly, an inverse correlation between SSTR2 and Ki-67 expressions was observed (44%) in MEC tissue. Uptake of 68Ga-DOTATATE was visualized using PET-CT imaging in 40% of patients, across metastatic MEC and ACC. All observations were found to be statistically significant. CONCLUSION This study confirms the expression of SSTR2 in glandular salivary carcinomas and an inverse correlation in expression levels between SSTR2 and Ki-67. This lays a foundation for novel treatment options in salivary metastatic cancers where SSTR2 may be a potential novel therapeutic target.
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Affiliation(s)
- Amichay Meirovitz
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel.
| | - Karny Shouchane-Blum
- Hebrew University Medical School, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Evgeniya Bersudski
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Nir Hirshoren
- Department of Otolaryngology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Ross Abrams
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Aron Popovtzer
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Marina Orevi
- Department of Nuclear Medicine, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Jeffrey Weinberger
- Department of Otolaryngology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
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12
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Liao QN, Fang ZK, Chen SB, Fan HZ, Chen LC, Wu XP, He X, Yu HP. Pleomorphic adenoma of the trachea: A case report and review of the literature. World J Clin Cases 2020. [DOI: 10.12998/wjcc.v8.i23.6021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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13
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Liao QN, Fang ZK, Chen SB, Fan HZ, Chen LC, Wu XP, He X, Yu HP. Pleomorphic adenoma of the trachea: A case report and review of the literature. World J Clin Cases 2020; 8:6026-6035. [PMID: 33344601 PMCID: PMC7723722 DOI: 10.12998/wjcc.v8.i23.6026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pleomorphic adenoma (PA) is the most common benign tumor that occurs in the salivary glands; however, tracheobronchial PA is rarely observed. To the best of our knowledge, fewer than 50 cases have been reported in the literature. We report a 49-year-old woman who had been treated for asthma for 2 years before being diagnosed with PA of the trachea.
CASE SUMMARY A 49-year-old woman was referred to our hospital due to dyspnea upon exertion and chronic cough with wheezing for 2 years. Laboratory tests showed an elevated white blood cell count, absolute neutrophil count, and percentage of neutrophils. A chest computerized tomography scan showed a well-defined, soft-tissue density lesion measuring 2.4 cm × 2.1 cm in the lower trachea. Flexible bronchoscopy revealed that nearly 90% of the tracheal lumen was obstructed. The histopathological and immunohistochemistry features suggested PA of the trachea. Furthermore, we review the characteristics of 29 patients with tracheobronchial PA over the last 30 years.
CONCLUSION Tracheobronchial PA occurs without gender predominance, mostly in the lower or upper trachea, and has a low recurrence rate. The median age at diagnosis is 48 years. The most common symptoms are cough, stridor, dyspnea, and wheezing.
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Affiliation(s)
- Qian-Nuan Liao
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Ze-Kui Fang
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Shu-Bing Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Hui-Zhen Fan
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Li-Chang Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Xi-Ping Wu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Xi He
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
| | - Hua-Peng Yu
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
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Misra S, Behera BK, Preetam C, Mohanty S, Mahapatra RP, Tapuria P, Elayat A, Nayak A, Kotkar K, McNeil JS, Blank RS. Peripheral Cardiopulmonary Bypass in Two Patients With Symptomatic Tracheal Masses: Perioperative Challenges. J Cardiothorac Vasc Anesth 2020; 35:1524-1533. [PMID: 33339662 DOI: 10.1053/j.jvca.2020.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/18/2020] [Indexed: 11/11/2022]
Abstract
Tracheal tumors or masses causing critical airway obstruction require resection for symptom relief. However, the location and extent of these tumors or masses often preclude conventional general anesthesia and tracheal intubation. Peripheral cardiopulmonary bypass often is required before anesthetizing these patients. Herein, two cases of patients with tracheal masses, in whom awake peripheral cardiopulmonary bypass was instituted, are reported. The first case was that of an obese male child weighing 102 kg, with tracheal rhinoscleroma, who developed Harlequin, or north-south, syndrome after institution of femorofemoral venoarterial partial cardiopulmonary bypass. The second case was that of a female patient with adenoid cystic carcinoma of the trachea causing near-total central airway occlusion. She had severe pulmonary artery hypertension, which prevented the use of venovenous bypass. Instead, femoral vein-axillary artery venoarterial bypass was established to avoid Harlequin syndrome. Some of the challenges encountered were the development of Harlequin syndrome with risk of myocardial and cerebral ischemia, type and conduct of extracorporeal bypass, choice of monitoring sites, and provision of regional anesthesia for peripheral extracorporeal cannulations. Management of such patients needs frequent troubleshooting and multidisciplinary coordination for a successful surgical outcome.
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Affiliation(s)
- Satyajeet Misra
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
| | - Bikram Kishore Behera
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Chappity Preetam
- Department of ENT, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Satyapriya Mohanty
- Department of Cardiac Surgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Rudra Pratap Mahapatra
- Department of Cardiac Surgery, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Priyank Tapuria
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Anirudh Elayat
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Anindya Nayak
- Department of ENT, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Kunal Kotkar
- Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - John S McNeil
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA
| | - Randal S Blank
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA
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15
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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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16
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Al Asmar R, Shweihat Y, Adams C, Mezughi H, Suliman MS. Tracheolaryngeal Squamous Cell Carcinoma with Extensive Mucosal Spread Without Metastasis in a Female. Cureus 2020; 12:e7219. [PMID: 32274277 PMCID: PMC7141800 DOI: 10.7759/cureus.7219] [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: 11/05/2022] Open
Abstract
Tracheal tumors remain one of the most interesting and challenging respiratory tumors. Usually, with the more invasive histologic subtypes, cancer has already invaded surrounding structures at the time of diagnosis. We present an unusual case of primary tracheal squamous cell carcinoma with an extensive mucosal spread at the time of diagnosis without any invasion of surrounding organs or distant metastasis. We discuss the unique features and our treatment approach to this unusual presentation. We also discuss the various epidemiologic, diagnostic and treatment aspects of upper airways tumors of the hypopharynx, larynx, and trachea that can help patients achieve more favorable outcomes.
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Affiliation(s)
- Rania Al Asmar
- Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, Huntington, USA
| | - Yousef Shweihat
- Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, Huntington, USA
| | - Catherine Adams
- Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, Huntington, USA
| | - Haitem Mezughi
- Pulmonology, Marshall University, Joan C. Edwards School of Medicine, Huntington, USA
| | - Mohamed S Suliman
- Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, Huntington, USA
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17
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Spatola C, Tocco A, Marletta D, Milazzotto R, Marletta F, Pergolizzi S, Migliore M, Basile A, Privitera G, Acquaviva G. Adenoid cystic carcinoma of trachea: long-term disease control after endoscopic surgery and radiotherapy. Future Oncol 2019; 16:33-39. [PMID: 31793391 DOI: 10.2217/fon-2018-0685] [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: 11/21/2022] Open
Abstract
Aim: Adenoid cystic carcinoma is a rare tumor of head and neck region and its development in the thoracic region is even less frequent. This implies the absence of guidelines for therapeutic management and a consequent case-by-case approach. The role of radiotherapy is not yet clearly defined, but intensity-modulated radiotherapy allows for improved organ-at-risk sparing. Materials & methods: We have collected the cases of four patients treated at our institutions by the means of intensity-modulated radiotherapy, after endoscopic resection. Results & conclusion: Patients treated achieved long-term disease control of about 5 years, with a minimal acute toxicity. Longer follow-up is needed to drain conclusion on the impact of this treatment on overall survival.
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Affiliation(s)
- Corrado Spatola
- UOC Radiodiagnostica e Radioterapia, AOU Policlinico-VE di Catania 95125, Italy
| | - Alessandra Tocco
- UOC Radiodiagnostica e Radioterapia, AOU Policlinico-VE di Catania 95125, Italy
| | - Dario Marletta
- UOC Radioterapia AOOE Cannizzaro di Catania 95100, Italy
| | - Roberto Milazzotto
- UOC Radiodiagnostica e Radioterapia, AOU Policlinico-VE di Catania 95125, Italy
| | | | | | | | - Antonio Basile
- UOC Radiodiagnostica e Radioterapia, AOU Policlinico-VE di Catania 95125, Italy
| | - Giuseppe Privitera
- UOC Radiodiagnostica e Radioterapia, AOU Policlinico-VE di Catania 95125, Italy
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Djaković Ž, Janevski Z, Cesarec V, Slobodnjak Z, Stančić-Rokotov D. ADENOID CYSTIC CARCINOMA OF DISTAL TRACHEA: A CASE REPORT. Acta Clin Croat 2019; 58:777-779. [PMID: 32595264 PMCID: PMC7314305 DOI: 10.20471/acc.2019.58.04.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Primary malignant tumors of the trachea are very rare with the incidence of less than two per million people per year, and only ten percent of them are adenoid cystic carcinomas. Eighty percent of all tracheal tumors are malignant. Diagnosis is usually late because the symptoms mimic other conditions such as asthma. Clinical picture may sometimes be dramatic when airway is almost closed and emergency recanalization is necessary. Diagnosis is made by chest computed tomography scan or magnetic resonance imaging. Definitive treatment is surgical resection alone or followed by radiation therapy or radiation therapy alone. Radical resection is only accomplished in about half of all cases because of the submucosal tumor growth and limited length of tracheal resection. The role of adjuvant radiation therapy in negative resection margin cases is not clear but all patients with positive resection margin benefit from radiation therapy. We present a case of a 43-year-old patient with primary adenoid cystic carcinoma of distal trachea treated by emergency bronchoscopic recanalization and resection of the tracheal tumor with end-to-end anastomosis.
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Affiliation(s)
| | - Zoran Janevski
- Jordanovac Department of Thoracic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Vedran Cesarec
- Jordanovac Department of Thoracic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Zoran Slobodnjak
- Jordanovac Department of Thoracic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Dinko Stančić-Rokotov
- Jordanovac Department of Thoracic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia
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Takahashi M, Yorozuya T, Miyasaka Y, Kodama K, Yoshikawa T, Taya T, Mori Y, Ikeda K, Miyajima S, Chiba H, Takahashi H. A case of tracheal pleomorphic adenoma misdiagnosed as asthma. Oxf Med Case Reports 2019; 2019:omz111. [PMID: 31777662 PMCID: PMC6874862 DOI: 10.1093/omcr/omz111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/19/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
A 51-year-old woman had an incidental finding of a tracheal tumor during oesophagogastroduodenoscopy following the diagnosis of asthma for 2 months. A computed tomography scan revealed a 15-mm tumor in the subglottis. Endoscopic resection was performed safely, and pleomorphic adenoma was diagnosed histologically. The patient’s condition was satisfactory 30 months after the procedure. Tracheal pleomorphic adenoma is rare and may be misdiagnosed as asthma. If the tumor is large, surgery may be required; however, endoscopic polypectomy may be effective if the tumor is small. Therefore, early diagnosis of tracheal pleomorphic adenoma is important. At the first visit, the flow–volume curve suggested upper airway obstruction, which should have raised the suspicion of an upper airway obstruction. In patients with suspected asthma, early pulmonary function testing is needed to substantiate asthma diagnosis and prevent an alternative diagnosis being missed.
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Affiliation(s)
- Mamoru Takahashi
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Takahumi Yorozuya
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Yuki Miyasaka
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Kentaro Kodama
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Takumi Yoshikawa
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Tetsuya Taya
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Yuki Mori
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Kimiyuki Ikeda
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Satsuki Miyajima
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Hirofumi Chiba
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
| | - Hiroki Takahashi
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan
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20
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Mahmud T, Nasim Z, Saqib M, Fatima S. Intractable cough due to endobronchial chondroma. Respir Med Case Rep 2019; 29:100968. [PMID: 31768309 PMCID: PMC6872764 DOI: 10.1016/j.rmcr.2019.100968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 11/01/2022] Open
Abstract
A 62-year-old man, suffering from bronchial asthma was evaluated due to intractable cough. His dyspnea was controlled but cough remained unresponsive to escalation of asthma management steps. Cough occurred in bouts, especially during night time and was occasionally productive of mucoid sputum. Other than bilateral rhonchi on chest auscultation, remaining systemic examination was unremarkable. CT chest showed a mass lesion in the bronchus intermedius that was confirmed on bronchoscopy and was removed after electrocautery snare excision. Histopathology of the lesion was consistent with endobronchial chondroma. The patient experienced a dramatic resolution of cough post tumor removal. Follow up bronchoscopy after 24 months revealed no tumor recurrence.
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Affiliation(s)
- Talha Mahmud
- Department of Pulmonology, Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan
| | - Zanobia Nasim
- Department of Pulmonology, Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan
| | - Muhammad Saqib
- Department of Pulmonology, Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan
| | - Saira Fatima
- Department of Pathology & Laboratory Medicine, Aga Khan University Hospital Karachi, Pakistan
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21
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Gao HX, Li Q, Chang WL, Zhang YL, Wang XZ, Zou XX. Carcinoma ex pleomorphic adenoma of the trachea: A case report. World J Clin Cases 2019; 7:2623-2629. [PMID: 31559302 PMCID: PMC6745320 DOI: 10.12998/wjcc.v7.i17.2623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/06/2019] [Accepted: 08/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Carcinoma ex pleomorphic adenoma (CXPA) is defined as a malignant salivary gland tumor arising from a primary or recurrent pleomorphic adenoma. Only three cases of CXPA of the trachea have been reported in the literature.
CASE SUMMARY We report a case of tracheal CXPA in a 55-year-old woman, who presented with a more than 3-mo history of progressive dyspnea. Computed tomography of the neck and thorax revealed an inhomogeneous, broad-based lesion arising from the tracheal wall on the right side. Endoscopy revealed a subglottic neoplasm causing up to 90% luminal stenosis. The tumor was resected using a high-frequency electrosurgical snare combined with argon plasma coagulation. Histopathology and immunohistochemistry revealed that the tumor was a CXPA of the trachea.
CONCLUSION We report the fourth case of tracheal CXPA, and present the first instance of resection of CXPA using high-frequency electrosurgical snare and laser ablation. We also discuss the pathogenesis, diagnosis, histopathology, and systemic therapy of this rare disease.
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Affiliation(s)
- Heng-Xing Gao
- Respiratory Department, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Quan Li
- Department of Radiology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Wen-Li Chang
- Department of Pathology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Ya-Long Zhang
- Department of Pathology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Xiao-Zhi Wang
- Respiratory Department, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Xue-Xue Zou
- Department of Radiology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
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22
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Wang Y, Cai S, Gao S, Xue Q, Mu J, Gao Y, Wang Y, Tan F, Bi N, Sun N, Li N, Hu X, Li J, Guo W, Mao S, Zhou L, Gao Y, He J. Tracheobronchial Adenoid Cystic Carcinoma: 50-Year Experience at the National Cancer Center, China. Ann Thorac Surg 2019; 108:873-882. [PMID: 31026435 DOI: 10.1016/j.athoracsur.2019.03.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/19/2019] [Accepted: 03/21/2019] [Indexed: 02/08/2023]
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Tripathy S, Shamim SA, Behera A, Bal C, Kumar R. Adenoid Cystic Carcinoma of Trachea: Findings on 18F FDG Positron Emission Tomography-Computed Tomography. Indian J Nucl Med 2019; 34:249-250. [PMID: 31293313 PMCID: PMC6593938 DOI: 10.4103/ijnm.ijnm_172_18] [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: 11/04/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) of the trachea is the second most common tumor of trachea after squamous cell carcinomas. It arises from the submucosal layer and predominantly has a rapid locoregional spread. We describe the 18F FDG positron emission tomography-computed tomography findings of a 51-year-old woman, a biopsy-proven case of ACC of trachea who underwent the scan for initial staging.
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Affiliation(s)
- Sarthak Tripathy
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shamim Ahmed Shamim
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Abhishek Behera
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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24
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Ning Y, He W, Bian D, Xie D, Jiang G. Tracheo-bronchial adenoid cystic carcinoma: A retrospective study. Asia Pac J Clin Oncol 2019; 15:244-249. [PMID: 31111681 DOI: 10.1111/ajco.13162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Adenoid cystic carcinoma (ACC) of the trachea and bronchus is rare, representing 1% of all respiratory tract cancers. We presented our experiences in treating tracheal-bronchial ACC and the results of long-term surveillance. METHODS We conducted a retrospective study of treating tracheo-bronchial ACC. From 2009 to 2014, 42 patients presented to our department. All of them received surgical resection and adjunctive therapy. RESULTS R0 resections were achieved in 33 patients, whereas 15 patients whose lesions spread outside the tracheo-bronchial lumens. Nine patients had R1 resections followed by radiation and chemotherapy. The 5 year survival rate of R1 resection group showed no difference compared to the R0 resection group, but the 5 year disease-free survival rate showed difference in extra-lumenal invasion (ELI) and non-ELI group (P = 0.0357 < 0.05), although no difference was seen in the overall survival rate in these two groups. CONCLUSIONS ACC of the trachea and bronchus is a rare and low-to-moderate grade malignant tumor. When the R0 resection is over risky or may cause mortal complication, the R1 resection with adjunctive therapy is acceptable for patients to obtain a promising prognosis, whereas pathological ELI is an adverse prognostic indicator.
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Affiliation(s)
- Ye Ning
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wenxin He
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dongliang Bian
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dong Xie
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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Wo Y, Li S, Wang Y, Lu T, Qin Y, Sun X, Jiao W. Predictors of nodal metastasis and prognostic significance of lymph node ratio and total lymph node count in tracheobronchial adenoid cystic carcinoma. Cancer Manag Res 2018; 10:5919-5925. [PMID: 30510459 PMCID: PMC6250114 DOI: 10.2147/cmar.s182069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose To identify potential risk factors of lymph node metastasis and to verify the prognostic significance of the lymph node ratio (LNR) and the total number of lymph nodes examined (NNE) in tracheobronchial adenoid cystic carcinoma (ACC) patients, using a large population-based database. Patients and methods From Surveillance, Epidemiology, and End Results database, we identified 263 patients with tracheobronchial ACC in whom complete lymph node data could be obtained. Logistic regression analysis was performed to determine predictive factors of nodal metastasis. X-tile software determined the optimal cut-off points for LNR and NNE. Kaplan- Meier analyses and Cox regression models were adopted for survival analysis. Results Of 263 patients, 75 (28.5%) had lymph node involvement. Tumors of bronchial origin (P<0.001) and tumors larger than 30 mm (P<0.001) were associated with a higher likelihood of nodal involvement. Examination of more than ten lymph nodes could avoid understaging and resulted in improved survival; meanwhile, patients with a LNR of 0.07 or less had favorable prognosis. Conclusion Patients with tracheobronchial ACC have significant risk of lymph node metastasis. Bronchial ACC and larger tumor size are both risk factors of lymph node metastasis. LNR and NNE may provide a more precise prediction of survival and could be taken into account in future clinical work.
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Affiliation(s)
- Yang Wo
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
| | - Shicheng Li
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
| | - Yuanyong Wang
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
| | - Tong Lu
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
| | - Yi Qin
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
| | - Xiao Sun
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
| | - Wenjie Jiao
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China,
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26
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Tapias LF, Shih A, Mino-Kenudson M, Muniappan A, Gaissert HA, Lanuti M, Mathisen DJ, Ott HC. Programmed death ligand 1 and CD8+ immune cell infiltrates in resected primary tracheal malignant neoplasms. Eur J Cardiothorac Surg 2018; 55:691-698. [DOI: 10.1093/ejcts/ezy370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/10/2018] [Accepted: 09/25/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Luis F Tapias
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Angela Shih
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Ashok Muniappan
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Henning A Gaissert
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Lanuti
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Douglas J Mathisen
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Harald C Ott
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
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27
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Abstract
RATIONALE Tracheobronchial benign tumors are uncommon; particularly, bronchial pleomorphic adenoma is one of the rarest benign tumors that develop in bronchus (only 7 reported cases, among which only 4 cases of pleomorphic adenoma were seen arising from right main bronchus). PATIENT CONCERNS In this report, a 38-year-old woman suffered from progressive shortness of breath for 5 years due to right main bronchial pleomorphic adenoma. DIAGNOSES The patient was diagnosed as right main bronchial pleomorphic adenoma based on chest computed tomography enhanced scan, bronchoscopy, and histological examination. INTERVENTIONS An electrosurgical snare was performed to resect the neoplasm and several APC were administered at the sites of the resection to provide hemostasis and further coagulate for the residual neoplasm. OUTCOMES The patient was free of symptoms and the lumen of right main bronchus was clear during the follow-up period for 10 months without any procedure-related complications. LESSONS Bronchial pleomorphic adenoma is extremely rare, however, we should take it into consideration if a patient suffered from shortness of breath without an exact cause.
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Affiliation(s)
- Zhixing Zhu
- Department of Pulmonary and Critical Care Medicine
| | | | - Dongyong Yang
- Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospital of Fujian Medical University, Respiratory Medicine Center of Fujian Province, Licheng District, Quan Zhou, P.R. China
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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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Himeji D, Kawaguchi T, Setoguchi K, Koreishi S. Successful Treatment of Life-threatening Tracheal Stenosis Caused by Malignancy with a Self-expanding Hybrid Stent. Intern Med 2018; 57:259-263. [PMID: 29093400 PMCID: PMC5820047 DOI: 10.2169/internalmedicine.9164-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Tracheal stenosis caused by malignancy is a life-threatening complication. We performed stent therapy in two patients using the AERO™ stent, launched in late 2016 in Japan. One patient presented with stenosis of the trachea due to adenoid cystic carcinoma and the other with stenosis of the trachea due to esophageal cancer. Both patients showed improved symptoms, and no complications were identified. This is the first report of a favorable outcome with the use of this hybrid stent in Japan, and the findings suggest that insertion of the AERO hybrid stent is an effective way to improve patients' quality of life.
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Affiliation(s)
- Daisuke Himeji
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Takeshi Kawaguchi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Kensuke Setoguchi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Sakuya Koreishi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
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31
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Je HU, Song SY, Kim DK, Kim YH, Jeong SY, Back GM, Choi W, Kim SS, Park SI, Choi EK. A 10-year clinical outcome of radiotherapy as an adjuvant or definitive treatment for primary tracheal adenoid cystic carcinoma. Radiat Oncol 2017; 12:196. [PMID: 29202770 PMCID: PMC5716005 DOI: 10.1186/s13014-017-0933-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/15/2017] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate the role of radiotherapy (RT) as an adjuvant or definitive treatment in primary tracheal adenoid cystic carcinoma (ACC) for local tumor control and survival. Methods A retrospective chart review was performed in 22 patients treated with adjuvant or definitive RT for primary tracheal ACC at a single center between November 1994 and December 2008. Results Thirteen and 9 patients received adjuvant and definitive RT, respectively. Microscopic residual disease after surgery was pathologically reported in 11 patients. The median RT dose was 59.4 Gy for adjuvant and 74.4 Gy for definitive RT. The overall response rate for definitive RT was 77.8%. Six patients in the definitive RT group exhibited local progression (LP), whereas 14 patients in both groups exhibited distant metastasis. The most common recurrence site in cases of treatment failure was the lung parenchyma. The median follow-up duration was 123 months, and the 10-year overall survival (OS) rate was 54.2%. Although LP was the most common cause of death (4 patients), two-thirds of the patients treated with definitive RT lived for >5 years. The 5-year and 10-year LP-free survival (LPFS) rates in the definitive RT group were 66.7 and 26.7%, respectively. Patients with higher RT dose by brachytherapy boost had good 5-year OS, 83.3%, and showed no local progression till 5-years. Most of the RT-induced side-effects were mild and tolerable, but 2 patients died of tracheal stenosis without any tumor recurrence. Conclusions Adjuvant RT may be suitable for controlling microscopic residual disease, whereas definitive RT may yield appropriate long-term survival in >50% patients with unresectable tracheal ACC. Dose escalation should be considered to warrant long-term survival in definitive RT.
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Affiliation(s)
- Hyoung Uk Je
- Department of Radiation Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Si Yeol Song
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Dong Kwan Kim
- Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yong-Hee Kim
- Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seong-Yun Jeong
- Asan institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Geum Mun Back
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.,Department of Medical Health Science, Kangwon National University Graduate School, Chuncheon, South Korea
| | - Wonsik Choi
- Department of Radiation Oncology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Su Ssan Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Seung-Il Park
- Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun Kyung Choi
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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32
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Al Khatib S, Asha W, Khzouz O, Barakat F, Khader J. Advanced Tracheal Adenoid Cystic Carcinoma with Thyroid Invasion Mimicking Thyroid Cancer Treated with Definitive Radiation: Case Report and Review of the Literature. Case Rep Oncol 2017; 10:706-712. [PMID: 28878654 PMCID: PMC5582503 DOI: 10.1159/000479225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 12/16/2022] Open
Abstract
A 54-year-old female patient, a breast cancer survivor and a case of unresectable adenoid cystic carcinoma of the trachea, with thyroid invasion, presented with suprasternal neck swelling mimicking thyroid primary. A literature search was undertaken to highlight this rare presentation. There have been few reports in the literature describing tracheal adenoid cystic carcinoma involving the thyroid.
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Affiliation(s)
- Sondos Al Khatib
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Wafa Asha
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Omar Khzouz
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Farid Barakat
- Department of Pathology, King Hussein Cancer Center, Amman, Jordan
| | - Jamal Khader
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
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Bhandari V, Ladia DD, Kausar M, Varma A. Definitive radiotherapy for inoperable adenoid cystic carcinoma of the trachea: A rare case report. Lung India 2017; 34:73-75. [PMID: 28144065 PMCID: PMC5234203 DOI: 10.4103/0970-2113.197117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) of the trachea is rare; it represents 1% of all respiratory tract cancers. It is generally considered as a slow-growing, with prolonged clinical course. Most patients present with dyspnea, and the symptoms often mimic those of asthma or chronic bronchitis. Surgical resection is the mainstay of treatment often combined to radiotherapy because of close surgical margins. When surgery is not possible, most tumors respond to radiotherapy alone which often results in long periods of remission. There is no consensus on the best treatment for locally advanced inoperable ACC of trachea. This case report describes a 51-year-old woman unresectable ACC of trachea due to comorbid conditions, successfully managed by intensity modulated radiotherapy. At 8 months follow-up, the patient is healthy and asymptomatic.
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Affiliation(s)
- Virendra Bhandari
- Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
| | - Desh Deepak Ladia
- Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
| | - Mehlam Kausar
- Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
| | - Amit Varma
- Department of Radiation Oncology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
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Garg R, Saini S, Kumar V, Gupta N. Emergency airway management of intratracheal tumor in a patient with respiratory distress. J Anaesthesiol Clin Pharmacol 2017; 33:133-134. [PMID: 28413295 PMCID: PMC5374822 DOI: 10.4103/0970-9185.168258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Rakesh Garg
- Department of Anesthesiology and Palliative Care, Dr. Brairch, All India Institute of Medical Sciences, New Delhi, India
- Address for correspondence: Dr. Rakesh Garg, Department of Anaesthesiology, DR. Brairch, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029, India. E-mail:
| | - Shalini Saini
- Department of Anesthesiology and Palliative Care, Dr. Brairch, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Kumar
- Department of Anesthesiology and Palliative Care, Dr. Brairch, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Anesthesiology and Palliative Care, Dr. Brairch, All India Institute of Medical Sciences, New Delhi, India
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35
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Kharchenko VP, Chkhikvadze VD, Gvarishvili AA, Pan'shin GA. [Adenocystic carcinoma of the trachea]. Khirurgiia (Mosk) 2016:4-11. [PMID: 28008895 DOI: 10.17116/hirurgia20161124-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It is presented 40-years experience of tracheal adenocystic carcinoma diagnosis and management in 144 patients. Peculiarities of clinical course and choice of diagnostic and therapeutic measures are discussed in relation to stenosis and hypoxia degree and severity of accompanying inflammatory complications of trachea, bronchi and lungs. Technical tools and original methods of resection and reconstruction of trachea and it's bifurcation after extended lung resection are described. Surgical management is carried out in 96 patients: all patients underwent circular resection of trachea (77) or it's bifurcation (19). Morbidity rate was 22.9% and mortality - 3.1%. Additional radiotherapy was carried out in 50 patients. 41 patients underwent radiotherapy alone. Radiotherapy improves remote results of management. 5-and 10-year survival rate was 78.3±6.1 and 45.9±7.9% after surgery alone, 92.0±3.9 and 77.1±6.5% after combined treatment and 76.4±6.5 and 55.0±10.7% after radiotherapy alone respectively.
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Affiliation(s)
| | | | | | - G A Pan'shin
- Russian Research Center of Roentgenoradiology of Russia
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36
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Huston B, Froloff V, Mills K, McGee M. Adenoid Cystic Carcinoma of the Trachea Resulting in Fatal Asphyxia. J Forensic Sci 2016; 62:244-246. [DOI: 10.1111/1556-4029.13236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/13/2015] [Accepted: 05/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Butch Huston
- Ramsey County Medical Examiner's Office; 300 East University Avenue St. Paul MN 55130
| | - Victor Froloff
- Ramsey County Medical Examiner's Office; 300 East University Avenue St. Paul MN 55130
| | - Kelly Mills
- Ramsey County Medical Examiner's Office; 300 East University Avenue St. Paul MN 55130
| | - Michael McGee
- Ramsey County Medical Examiner's Office; 300 East University Avenue St. Paul MN 55130
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Abstract
Tumors of trachea and bronchi are uncommon and can occur in the form of benign or low- and high-grade malignant tumors. Although tracheobronchial tumors (TBTs) represent only 0.6% of all pulmonary tumors, they are clinically significant. Delays in diagnosis of these tumors commonly occur because the signs and symptoms caused by these tumors are nonspecific and chest radiographs are often considered unremarkable. Therefore, novel radiological techniques and better access to flexible bronchoscopy enable detection of larger number of TBT. The purpose of this article is to provide a review of tracheal and bronchial tumors and discuss significant aspects of the different TBT with focus on clinical manifestations and diagnostic procedures.
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Affiliation(s)
- Ruza Stevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia;; Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia
| | - Branislava Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia;; Clinic for Pulmonology, Clinical Center of Serbia, Belgrade, Serbia
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38
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Kwon JH, Jang SJ, Song JS, Choi SH, Cho KJ. Liquid-based sputum cytology of bicomponent mucin-producing adenocarcinoma of the trachea with histologic comparison. Diagn Cytopathol 2016; 44:1120-1124. [PMID: 27546521 DOI: 10.1002/dc.23570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/14/2016] [Accepted: 08/09/2016] [Indexed: 11/09/2022]
Abstract
Primary tracheal adenocarcinomas are rare. Here, we report on the liquid-based sputum cytology of a bicomponent mucin-producing tracheal adenocarcinoma with histologic and immunohistochemical comparison. A 72-year-old man presented with dyspnea. Computed tomography revealed a lobulated mass in the mid-trachea. Sputum cytology showed clusters of atypical cuboidal cells that have pleomorphic and hyperchromatic nuclei and intracytoplasmic mucin. There were additional bland-looking components of regular clusters of cuboidal epithelial cells. These cells were initially evaluated as benign cells. Sleeve resection revealed a 3.7-cm-sized transmural mass, composed of tubulopapillary cuboidal epithelial cell structures. Half of the tumor comprised of bland-looking epithelial cells with small nuclei and eosinophilic cytoplasm; the remainder comprised of hyperchromatic cells with larger, distinct nucleoli. Direct interfaces between these components were observed, and both of these components equally displayed the characteristics of invasion and p53 expression. Two cell types in sputum cytology were retrospectively evaluated as adenocarcinomas of different grades. The patient has not shown recurrence for 8 months, postoperatively. Diagn. Cytopathol. 2016;44:1120-1124. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jeong-Hwa Kwon
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Se Jin Jang
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Joon Seon Song
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung-Ho Choi
- Department of Otorhinolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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39
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Sims SEG, Li F, Lostracco T, Chaturvedi A, Son H, Wandtke J, Hobbs S. Multidimensional evaluation of tracheobronchial disease in adults. Insights Imaging 2016; 7:431-48. [PMID: 27085884 PMCID: PMC4877354 DOI: 10.1007/s13244-016-0489-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/21/2016] [Accepted: 03/24/2016] [Indexed: 11/28/2022] Open
Abstract
The large airways can be affected by a wide spectrum of acquired benign and malignant diseases. These lesions may present as focal or diffuse processes and with narrowing or widening of the airway. Some of these may be asymptomatic for quite some time and may be incidentally detected on imaging, while others may be symptomatic, causing airway compromise. There may be a characteristic radiograph and computed tomography (CT) appearance, suggesting a narrow differential. When the imaging findings are not definitive, tissue may be obtained for pathological analysis. It behooves the radiologist to be familiar with the pathologic findings that correlate with the radiographic or CT appearance of the most frequently seen large airway lesions. In this way, we may improve our diagnostic accuracy. This paper will present the imaging findings of the most prevalent tracheobronchial lesions along with any associated pathology. Teaching Points • The large airways can be affected by many acquired benign and malignant diseases.• Large airway lesions may present as focal or diffuse processes, with narrowing or widening.• There may or may not be characteristic imaging appearance of large airway disease.• If imaging findings are not definitive, tissue may be obtained for pathological analysis.
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Affiliation(s)
- Susan E. G. Sims
- />Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 USA
| | - Faqian Li
- />Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 76, C420 Mayor Building, 420 Delaware Street, NE, Minneapolis, MN 55455 USA
| | - Thomas Lostracco
- />Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 USA
| | - Abhishek Chaturvedi
- />Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 USA
| | - Hongju Son
- />Department of Radiology, Einstein Healthcare Network, 5501 Old York Road, Philadelphia, PA 19141 USA
| | - John Wandtke
- />Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 USA
| | - Susan Hobbs
- />Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 USA
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Shroff GS, Ocazionez D, Vargas D, Carter BW, Wu CC, Nachiappan AC, Gupta P, Restrepo CS. Pathology of the Trachea and Central Bronchi. Semin Ultrasound CT MR 2016; 37:177-89. [DOI: 10.1053/j.sult.2015.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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41
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Maia D, Elharrar X, Laroumagne S, Maldonado F, Astoul P, Dutau H. Malignant transformation of a tracheal chondroma: The second reported case and review of the literature. REVISTA PORTUGUESA DE PNEUMOLOGIA 2016; 22:283-6. [PMID: 27185409 DOI: 10.1016/j.rppnen.2016.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 02/18/2016] [Accepted: 04/15/2016] [Indexed: 11/17/2022] Open
Abstract
Tracheal tumors are rare, representing only 0.2% of the respiratory tract malignancies. Chondrosarcoma arising in the trachea was first described in 1959 by Jackson et al. and since then only 20 cases have been described. We report the second documented case of malignant transformation from an endotracheal chondroma, in a 75-year-old woman, and review the literature.
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Affiliation(s)
- D Maia
- Service de Oncologie Thoracique - Maladies de La Plèvre - Pneumologie Interventionnelle, Hôpital Nord, Marseille, France
| | - X Elharrar
- Service de Oncologie Thoracique - Maladies de La Plèvre - Pneumologie Interventionnelle, Hôpital Nord, Marseille, France
| | - S Laroumagne
- Service de Oncologie Thoracique - Maladies de La Plèvre - Pneumologie Interventionnelle, Hôpital Nord, Marseille, France
| | - F Maldonado
- Department of Medicine, Vanderbilt University, Nashville, USA
| | - P Astoul
- Service de Oncologie Thoracique - Maladies de La Plèvre - Pneumologie Interventionnelle, Hôpital Nord, Marseille, France; Aix-Marseille University, Marseille, France
| | - H Dutau
- Service de Oncologie Thoracique - Maladies de La Plèvre - Pneumologie Interventionnelle, Hôpital Nord, Marseille, France.
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Varghese A, Suneha S, Watkinson JC. Adenoid Cystic Carcinoma of Trachea. Indian J Surg 2016; 79:67-69. [PMID: 28331271 DOI: 10.1007/s12262-016-1457-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 02/10/2016] [Indexed: 12/30/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is the second most common primary malignant tumor of the trachea, after squamous cell carcinoma. Patients present with upper airway obstructive symptoms and signs including dyspnoea, cough, haemoptysis, and stridor which are often insidious, delaying diagnosis and optimal management. Described here is an unusual case of primary ACC cervical trachea with concomitant micropapillary thyroid carcinoma (microPTC) in a middle-aged lady presenting with cough and breathing difficulty since 3 months.
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Affiliation(s)
- Ashish Varghese
- Otolaryngology-Head and Neck Surgery Department, Christian Medical College, Ludhiana, 141008 Punjab India
| | - Swati Suneha
- Otolaryngology-Head and Neck Surgery Department, Christian Medical College, Ludhiana, 141008 Punjab India
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43
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Hassan M, Quraeshi S, Zubairi ABS. A rare cause of recurrent wheeze and seizures. BMJ Case Rep 2015; 2015:bcr-2015-213283. [PMID: 26677161 DOI: 10.1136/bcr-2015-213283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 34-year-old woman presented with recurrent attacks of breathlessness and seizures. The patient's condition worsened during the course of her hospital stay, as a result of which she had to be intubated twice. Radiological studies showed a mass in the trachea and the subsequent biopsy of the mass revealed an infiltrating carcinoma with morphological features of adenoid cystic carcinoma.
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44
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Endoscopic treatment of primary benign central airway tumors: Results from a large consecutive case series and decision making flow chart to address bronchoscopic excision. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2015; 41:1437-42. [PMID: 26329785 DOI: 10.1016/j.ejso.2015.08.157] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/15/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Benign tracheo-bronchial neoplasms are rare, but potentially dangerous conditions with life threatening consequences. Tumor removal should be pursued by methods minimizing the procedural stress. The role of endoscopic treatment, as an alternative to open surgery, remains controversial. OBJECTIVES report the twelve-years endoscopic experience in Rome, Italy. Fifty-seven benign tracheo-bronchial tumors were diagnosed and 130 tracheo-bronchial resections by rigid bronchoscopy performed. METHODS we identified histotypes associated with higher recurrence rate and assessed their relationship with gender, age and tracheo-bronchial location. We provided data on safety and complications and suggested a decision making flow chart to address the patients to endoscopic resection. RESULTS complete eradication after a single procedure without recurrence at 2 years was obtained in 63.1% of cases (36/57). Need of a second intervention within few months but no further recurrence at follow up was seen in a further 8.8% (5/57). Histotypes associated with recurrence were papillomas and inflammatory polyp. Seven patients (12.3%) were addressed to surgery because of multiple recurrence. Ten patients (17.5%) were lost at follow up. In case of recurrence, the bronchial biopsy was always repeated and no malignant transformation was observed. No major complications, pneumothorax or pneumomediastinum occurred. CONCLUSIONS endoscopic treatment of benign tracheo bronchial tumors is safe and effective, provided that the procedure is carefully and systematically planned. The rate of eradication is satisfactory and the incidence of complications negligible. This will encourage this approach as first line treatment especially in patients, frequently elderly people, having increased surgical risk due to concomitant respiratory failure or major comorbidities.
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45
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Laryngeal preservation in managing advanced tracheal adenoid cystic carcinoma. Case Rep Otolaryngol 2015; 2015:404586. [PMID: 25878915 PMCID: PMC4387972 DOI: 10.1155/2015/404586] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 03/12/2015] [Accepted: 03/15/2015] [Indexed: 11/17/2022] Open
Abstract
A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally.
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Zhang Y, Wang C, Zhang G, Wang Z, Wen X, Yang X, You J, Fu J. Case report of polymorphous low-grade adenocarcinoma in the trachea with metastasis to the right middle lobe bronchus. Thorac Cancer 2015; 6:220-3. [PMID: 26273362 PMCID: PMC4448480 DOI: 10.1111/1759-7714.12157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/25/2014] [Indexed: 11/28/2022] Open
Abstract
Polymorphous low-grade adenocarcinoma (PLGA) is a low-grade malignant infiltrative tumor of the minor salivary glands. According to data from PubMed (National Center for Biotechnology), one case of PLGA involving the left main bronchus and one case involving the right main and upper lobar bronchi have previously been reported. Here, we describe the first case of PLGA originating in the trachea with metastasis to the right middle lobe bronchus, all initially misdiagnosed as adenoid cystic carcinoma (ACC). It is particularly important to distinguish this tumor from other types of salivary gland tumors, especially ACC. Complete surgical excision is the curative treatment of choice for PLGA.
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Affiliation(s)
- Yong Zhang
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
| | - Chunbao Wang
- Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
| | - Guangjian Zhang
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
| | - Zhe Wang
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
| | - Xiaopeng Wen
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
| | - Xiaomei Yang
- Hospital 521 of China's Ordnance Industry Group Xi'an, Shannxi Province, China
| | - Jiangtao You
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
| | - Junke Fu
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Shannxi Province, China
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Franco I, Tente D, Coutinho D, Linhas R, Antunes A, Barroso A. Single symptomatic colonic metastasis as first presentation of a pulmonary mucoepidermoid carcinoma. CLINICAL RESPIRATORY JOURNAL 2015; 10:524-9. [DOI: 10.1111/crj.12251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 09/29/2014] [Accepted: 12/08/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Inês Franco
- Department of Pulmonology; Centro Hospitalar Vila Nova de Gaia/Espinho; Porto Portugal
| | - David Tente
- Department of Anatomic Pathology; Centro Hospitalar Vila Nova de Gaia/Espinho; Porto Portugal
| | - Daniel Coutinho
- Department of Pulmonology; Centro Hospitalar Vila Nova de Gaia/Espinho; Porto Portugal
| | - Rita Linhas
- Department of Pulmonology; Centro Hospitalar Vila Nova de Gaia/Espinho; Porto Portugal
| | - Ana Antunes
- Department of Pulmonology; Centro Hospitalar Vila Nova de Gaia/Espinho; Porto Portugal
| | - Ana Barroso
- Department of Pulmonology; Centro Hospitalar Vila Nova de Gaia/Espinho; Porto Portugal
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48
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Primary tracheal adenoid cystic carcinoma: adjuvant treatment outcome. Int J Clin Oncol 2014; 20:686-92. [DOI: 10.1007/s10147-014-0771-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/11/2014] [Indexed: 12/14/2022]
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Rasihashemi SZ, Rostambeigi N, Fakhrjou A. Mucinous adenocarcinoma of trachea: a rare case of primary tracheal tumor. Asian Cardiovasc Thorac Ann 2014; 21:363-5. [PMID: 24570511 DOI: 10.1177/0218492312454857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A primary tracheal tumor is not common, but adenocarcinoma is particularly rare. We describe a case of primary tracheal mucinous adenocarcinoma misdiagnosed as asthma in a 17-year-old girl. Computed tomography revealed an intraluminal partially obstructing mass in the mid portion of the trachea. A sleeve resection of the involved trachea with primary anastomosis was performed, followed by adjuvant radiotherapy. After 23 months of follow-up, there has been no recurrence.
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Abstract
We present the case of a 33-year-old woman who was being treated for bronchial asthma for 4 years. A tracheal tumor was evident on a computed tomography of the thorax and removed with argon plasma coagulation. It was diagnosed as pleomorphic adenoma of the trachea. It is a rare tracheal tumor without definite treatment guidelines. Our endoscopic approach to this rare lesion is discussed.
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