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Piórek A, Płużański A, Teterycz P, Tabor S, Winiarczyk K, Knetki‐Wróblewska M, Kowalski DM, Krzakowski M. Clinicopathological characteristics of patients with primary tracheal tumors: Analysis of eighty-nine cases. Thorac Cancer 2024; 15:878-883. [PMID: 38429910 PMCID: PMC11016403 DOI: 10.1111/1759-7714.15231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Primary tracheal tumors are very rare and the literature on this subject is limited. The most common histological type of primary tracheal tumors is squamous cell carcinoma (SCC), followed by adenoid cystic carcinoma (ACC). Limited knowledge exists regarding the behavior and outcomes of different histological types of tracheal cancers. The present study aimed to address this gap by assessing the significance of the histological type of primary tracheal tumors based on our own data and to review the literature. METHODS We carried out a retrospective analysis of 89 patients with primary tracheal tumors treated at the Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Poland, between 2000 and 2016. The study assessed patient demographics, tumor characteristics and treatment, with a focus on SCC, ACC, and other histological types. Different histological types were compared in terms of overall survival, disease-free survival, and progression-free survival. RESULTS SCC was the most frequently diagnosed histological type (56.2%), followed by ACC (21.3%). Patients with SCC were typically older (78% over 60 years), predominantly male (66%), and associated with smoking. In contrast, the ACC had a more balanced gender distribution and did not correlate with smoking. ACC displayed a significantly better prognosis, with a median overall survival of 129.4 months, compared with 9.0 months for SCC. CONCLUSION Histological type plays a crucial role in the prognosis of primary tracheal tumors. ACC demonstrated a more favorable outcome compared with SCC.
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Affiliation(s)
- Aleksandra Piórek
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Adam Płużański
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Paweł Teterycz
- Department of Soft Tissue/Bone Sarcoma and MelanomaMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
- Department of Computational OncologyMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Sylwia Tabor
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Kinga Winiarczyk
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Magdalena Knetki‐Wróblewska
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Dariusz M. Kowalski
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Maciej Krzakowski
- Department of Lung Cancer and Thoracic TumorsMaria Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
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Huang S, Peng X, Li H, Zhao J, Hou J. Successful endotracheal intervention for primary tracheal acinic cell carcinoma: A case report and literature review. Medicine (Baltimore) 2024; 103:e37033. [PMID: 38335397 PMCID: PMC10860940 DOI: 10.1097/md.0000000000037033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Primary tracheal acinic cell carcinoma (ACC) is an exceptionally rare malignancy, posing challenges in understanding its clinical behavior and optimal management. Surgical resection has traditionally been the primary treatment modality, but we present a compelling case of tracheal ACC managed with endotracheal intervention, challenging conventional approaches. PATIENT CONCERNS A 53-year-old woman presented with shortness of breath, cough, and hemoptysis. Enhanced computed tomography revealed an obstructive tracheal lesion, leading to her referral for further assessment. DIAGNOSIS Microscopic evaluation, immunohistochemistry, and clinical assessments confirmed primary tracheal ACC, an exceedingly rare condition with limited clinical insights. INTERVENTIONS We utilized rigid bronchoscopy to perform endotracheal intervention, successfully resecting the tumor and restoring tracheal patency. Postoperatively, the patient received no radiotherapy or chemotherapy. OUTCOMES The patient achieved complete recovery, with 24-month follow-up examinations indicating no recurrence or metastatic disease. Only minimal scar tissue remained at the resection site. CONCLUSION This case demonstrates the potential of endotracheal intervention as a curative approach for primary tracheal ACC, minimizing invasiveness and preserving tracheal function. Collaborative research efforts and extensive case reporting are crucial for advancing our understanding of this rare malignancy and optimizing treatment strategies for improved patient outcomes.
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Affiliation(s)
| | - Xinru Peng
- Ningxia Medical University, Ningxia, China
| | - Hailong Li
- Department of Respiratory Medicine, Ningxia Hospital of Integrated Traditional Chinese and Western Medicine, Ningxia, China
| | - Jiale Zhao
- Department of Respiratory Medicine, Ningxia Hospital of Integrated Traditional Chinese and Western Medicine, Ningxia, China
| | - Jia Hou
- Department of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical University, Ningxia, China
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3
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Lorandi LL, Ceccon FP, Callegari FM, Bacchi CE, Haddad L. Benign cervical schwannoma with tracheal invasion. Einstein (Sao Paulo) 2024; 22:eRC0528. [PMID: 38324847 PMCID: PMC10948098 DOI: 10.31744/einstein_journal/2024rc0528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/21/2023] [Indexed: 02/09/2024] Open
Abstract
Schwannomas commonly develop in the cervical region, 25% - 45% of cases are diagnosed in this anatomical region. Tracheal neurogenic tumors are exceedingly rare and can be misdiagnosed as invasive thyroid carcinomas or other infiltrating malignancies when present at the level of the thyroid gland. Here, we present a case of synchronous benign cervical schwannoma with tracheal invasion and papillary thyroid carcinoma in a patient who was initially hospitalized for COVID-19. The patient presented with dyspnea that was later found to be caused by tracheal extension of a cervical tumor. Surgical excision was performed, and the surgical team proceeded with segmental tracheal resection, removal of the cervical mass, and total thyroidectomy. The specimen was sent for pathological analysis, which revealed synchronous findings of a benign cervical schwannoma with tracheal invasion and papillary thyroid carcinoma. The literature on this subject, together with the present case report, suggests that neurogenic tumors should be included in the differential diagnosis of obstructing tracheal cervical masses. Surgical excision is the first-line of treatment for benign cervical schwannomas.
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Affiliation(s)
- Leonardo Lima Lorandi
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Israelita Albert EinsteinSão PauloSPBrazil Faculdade Israelita de Ciências da Saúde Albert Einstein , Hospital Israelita Albert Einstein , São Paulo , SP , Brazil .
| | - Fabio Pupo Ceccon
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein , São Paulo , SP , Brazil .
| | - Fabiano Mesquita Callegari
- Pathology DepartmentUniversidade Federal de São PauloSão PauloSPBrazil Pathology Department , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
| | - Carlos Eduardo Bacchi
- Laboratorio de Patologia Bacchi LtdaBotucatuSPBrazil Laboratorio de Patologia Bacchi Ltda , Botucatu , SP , Brazil .
| | - Leonardo Haddad
- Department of Otorhinolaryngology and Head and Neck SurgeryEscola Paulista de MedicinaUniversidade Federal de São PauloSão PauloSPBrazil Department of Otorhinolaryngology and Head and Neck Surgery , Escola Paulista de Medicina , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
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Kinoshita T, Ishii H, Sakazaki Y, Azuma K, Sasaki J, Tokito T, Tominaga M, Ogou E, Kawayama T, Hoshino T. Proton Beam Therapy as a Curative Treatment for a Young Case of Unresectable Tracheal Adenoid Cystic Carcinoma. Intern Med 2023; 62:2877-2881. [PMID: 36792199 PMCID: PMC10602834 DOI: 10.2169/internalmedicine.0574-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/28/2022] [Indexed: 02/16/2023] Open
Abstract
Primary tracheal adenoid cystic carcinoma (TACC) is a rare malignancy without an established treatment. Central airway obstruction due to TACC often decreases the quality of life and has life-threatening consequences. A 19-year-old man with unresectable TACC and central airway obstruction suffered from progressive cough and dyspnea after exercise. Proton beam therapy (PBT) was selected as the preferred treatment over systemic anti-cancer chemotherapy for TACC. PBT led to complete remission of TACC and the almost complete disappearance of the respiratory symptoms without adverse events. PBT is a useful and safe treatment for unresectable primary TACC.
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Affiliation(s)
- Takashi Kinoshita
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Yuki Sakazaki
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Jun Sasaki
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Masaki Tominaga
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Etsuyo Ogou
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
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Mikami E, Nakamichi S, Nagano A, Misawa K, Hayashi A, Tozuka T, Takano N, Noro R, Maebayashi K, Kubokura H, Terasaki Y, Kubota K, Seike M. Successful Treatment with Definitive Concurrent Chemoradiotherapy Followed by Durvalumab Maintenance Therapy in a Patient with Tracheal Adenoid Cystic Carcinoma. Intern Med 2023; 62:2731-2735. [PMID: 36642523 PMCID: PMC10569923 DOI: 10.2169/internalmedicine.1142-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/04/2022] [Indexed: 01/15/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare type of malignant tracheal tumor originating from the secretory glands. Complete surgical resection is the current standard of care for tracheal ACC. However, there have been few case reports of chemoradiotherapy for unresectable tracheal ACC. We herein report a 28-year-old man with unresectable tracheal ACC who received concurrent chemoradiotherapy (CCRT) followed by maintenance therapy with durvalumab. CCRT was completed with a good response and safety, and the patient is currently receiving durvalumab as maintenance therapy. Durvalumab after CCRT can be a treatment option for patients with unresectable tracheal ACC.
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Affiliation(s)
- Erika Mikami
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Atsuhiro Nagano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Kazuhito Misawa
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Anna Hayashi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Takehiro Tozuka
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Natsuki Takano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Rintaro Noro
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Katsuya Maebayashi
- Department of Radiology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Hirotoshi Kubokura
- Department of Thoracic Surgery, Graduate School of Medicine, Nippon Medical School Musashikosugi Hospital, Japan
| | - Yasuhiro Terasaki
- Department of Analytic Human Pathology, Nippon Medical School, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
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6
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Yang MQ, Wang ZQ, Li XF, Chen LQ, Zhang HN, Zhang KX, Xu HT. Primary acinic cell carcinoma of the trachea: A case report and literature review. Medicine (Baltimore) 2023; 102:e32871. [PMID: 36820581 PMCID: PMC9907908 DOI: 10.1097/md.0000000000032871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
RATIONALE Salivary gland-type acinic cell carcinoma (ACC) is a low-grade malignancy. Primary ACC of the trachea and lungs is rare; here, we describe 1 such case. The histological morphology of tracheal ACC was similar to that of its salivary gland-associated equivalent. Because of its rarity, it is easily misdiagnosed as another type of tracheal or lung tumor. Microscopic analysis of pathological features and immunohistochemistry help diagnose primary ACC of the trachea and lungs. PATIENT CONCERNS A 33-year-old female complained of shortness of breath and hemoptysis for 2 years, and reported the symptoms to have aggravated over the last 4 months. The patient was admitted to our hospital for further treatment. Enhanced computed tomography revealed a soft tissue density nodule shadow in the trachea, which was approximately 1.3 × 1.2 cm in size. DIAGNOSES Based on the clinical information, morphological features, and immunohistochemistry, the pathological diagnosis was primary ACC of the trachea. INTERVENTION The tracheal lesion was resected with an electric snare, electrotomy, freezing, and an argon knife using a rigid bronchoscope. OUTCOMES The patient's postoperative course was uneventful. LESSONS It is important to prevent misdiagnosis of this type of tumor as another type of lung tumor. Morphological and immunohistochemical features can be useful in diagnosing primary ACC of the trachea and lungs.
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Affiliation(s)
- Mai-Qing Yang
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Zhi-Qiang Wang
- Department of Orthopedics and Trauma, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Xiu-Feng Li
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Li-Qian Chen
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Hai-Ning Zhang
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Ke-Xin Zhang
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Hong-Tao Xu
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China
- * Correspondence: Hong-Tao Xu, Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang 110001, China (e-mail: )
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7
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Faccioli E, Comacchio G, Mammana M, Zambello G, Zuin A, Rea F. Tracheal resection and anastomosis for squamous cell carcinoma. Multimed Man Cardiothorac Surg 2022; 2022. [PMID: 35377973 DOI: 10.1510/mmcts.2022.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Tracheal malignant tumors are uncommon lesions. The rarity of this condition may generate uncertainties in the diagnosis and treatment. For this reason especially, the surgical treatment should be performed only in centers with a high expertise in tracheal surgery. If the involved tracheal tract is less than 4-5 cm and the tumor is localized, the treatment of choice is based on a segmental tracheal resection with an end-to-end anastomosis. In this video tutorial, we describe how we perform tracheal resection with an end-to-end anastomosis in a patient with a squamous cell carcinoma.
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Affiliation(s)
- Eleonora Faccioli
- Thoracic Surgery and Lung Transplant Unit, University Hospital of Padua, Italy
| | - Giovanni Comacchio
- Department of Cardio-Thoracic Surgery Padua University Hospital, Via Giustiniani 1 Padua (PD), Italy
| | - Marco Mammana
- Thoracic Surgery and Lung Transplant Unit, University Hospital of Padua, Italy
| | - Giovanni Zambello
- Thoracic Surgery and Lung Transplant Unit, University Hospital of Padua, Italy
| | - Andrea Zuin
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Federico Rea
- Division of Thoracic Surgery University of Padua via Giustiniani 2 35128 Padua Italy
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Wang Q, Tang W, Yang S, Chen Y. A Case of Solitary Laryngotracheal Lymphoma Evaluated by 18F-FDG PET/CT. Clin Nucl Med 2021; 46:686-687. [PMID: 33782279 DOI: 10.1097/rlu.0000000000003601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Solitary non-Hodgkin lymphoma of the trachea is extremely rare. Herein, we reported a case of solitary laryngotracheal lymphoma in a 55-year-old man. He complained of cough, tachypnea, and dyspnea. 18F-FDG PET/CT showed a hypermetabolic lesion in the subglottic larynx and upper cervical trachea. The subsequent histology and immunohistochemistry of the laryngotracheal lesion tissue confirmed the diagnosis of non-Hodgkin lymphoma (mucosa-associated lymphatic tissue lymphoma).
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9
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Keino D, Sudo A, Mizuno M, Sasaki K, Kinoshita A, Mori T. Diffuse Large B-Cell Lymphoma of the Trachea in a Child With Symptoms of Bronchial Asthma. J Pediatr Hematol Oncol 2021; 43:e187-e190. [PMID: 32366783 DOI: 10.1097/mph.0000000000001817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
Tracheal tumors are rare in children and manifest symptoms of airway obstruction. A 14-year-old boy with a 5-month history of dyspnea and wheezing was referred to our hospital. Although he had been initially diagnosed with bronchial asthma, computed tomography revealed tracheal tumors. Histologic examination showed only necrotic tissue. Thereafter, the systemic steroid treatment for bronchial asthma was tapered off. A second computed tomography scan revealed new lesions in the pancreas and lung. Biopsy of the pancreatic lesion revealed a diffuse large B-cell lymphoma. The patient was administered standard chemotherapy, following which he went into complete remission.
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Affiliation(s)
- Dai Keino
- Department of Pediatrics, St. Marianna University School of Medicine
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Akina Sudo
- Department of Pediatrics, St. Marianna University School of Medicine
| | - Masanori Mizuno
- Department of Pediatrics, St. Marianna University School of Medicine
| | - Keigo Sasaki
- Department of Pediatrics, Yokohama Rosai Hospital, Kanagawa, Japan
| | | | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine
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Zhao L, Zhao Y, Guo JD, Zeng Y, Yao F, Liu MN, Wang JM, Lv CX, Liu J, Fu XL, Zhao H, Cai XW. Effective Radiotherapy in Tracheobronchial Adenoid Cystic Carcinoma With Positive Surgical Margin. Ann Thorac Surg 2020; 112:1585-1592. [PMID: 33347849 DOI: 10.1016/j.athoracsur.2020.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/02/2020] [Accepted: 11/30/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The study aimed to evaluate the role of postoperative radiotherapy (PORT) in the treatment of trachea and main bronchus adenoid cystic carcinoma (ACC) with a positive surgical margin. METHODS Patients with pathologically confirmed trachea or main bronchus ACC operated on at Shanghai Chest Hospital were enrolled. Survival, univariate, and multivariate analyses were performed. The χ2 test was applied to analyze the failure patterns among different groups (R0/0: negative margin resection without PORT; R1/0: positive margin resection without PORT; R1/1: positive margin resection with PORT). RESULTS From January 2001 to December 2014, 77 patients were deemed eligible for the study. Pairwise comparisons showed that the overall survival rate of group R1/1 was comparable to that of group R0/0 (P = .438), and significantly longer than the rate of group R1/0 (P = .032). Additionally, the local disease-free survival rate of group R1/1 was much higher than that of group R0/0 (P = .023) and R1/0 (P = .001). Cox multivariate analysis identified the radiologic feature (P = .012) and PORT (P = .006) as significantly favorable prognostic factors for locoregional disease-free survival. By contrast, for overall survival, PORT (P = .032) was the only corresponding variable identified by univariate analysis. Furthermore, PORT significantly decreased the locoregional recurrence rate (P = .002) but not distant metastases (P > .999). CONCLUSIONS PORT helped patients with tracheobronchial ACC and microscopic positive surgical margins to achieve a similar outcome as patients with complete resection. R0 resection may not be necessary for tracheobronchial ACC if it is difficult to be completely resected.
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Affiliation(s)
- Lei Zhao
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Dong Guo
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ya Zeng
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Yao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mi-Na Liu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jia-Ming Wang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chang-Xing Lv
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Liu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Long Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Heng Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xu-Wei Cai
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
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Abstract
BACKGROUND Tracheal invasion is reported to occur in approximately one-third of the patients of locally advanced thyroid cancers. There is a paucity of data in literature with regard to the long-term outcomes of thyroid cancers with tracheal invasion. METHODS A total of 37 patients from our tertiary care center underwent radical surgery for tracheal involvement for differentiated thyroid cancers between the years 2002 and 2016. The variables pertaining to the demographics, clinical presentation, imaging, operative details and histopathology reports were captured from the patient's case records and analyzed. RESULTS Among the 37 patients, there were 21 males and 16 females. Majority of the patients (56.8%) were >55 years of age. Surgery (tracheal resection) was performed in the primary setting in 29 patients, whereas it was performed in a recurrent setting in 8 patients. As per the Shin classification, 3 patients belonged to Shin stage 1, 3 to Shin stage 2, 16 patients to Shin stage 3 and 15 patients to Shin stage 4. There was no 30 day postoperative mortality in our cohort. The median follow-up of our cohort was 175 months. The 5-, 10-, and the 15-year overall survivals of the entire cohort were 81.7%, 47.8%, and 35.9%, respectively. CONCLUSION Our series shows favorable long-term oncological outcomes of selected patients of thyroid cancers with tracheal resection and adds to the limited long-term data available in literature.
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Affiliation(s)
- Yogesh Tiwari
- Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Arvind Krishnamurthy
- Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
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12
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McLean-Holden AC, Moore SA, Gagan J, French CA, Sher D, Truelson JM, Bishop JA. NUT Carcinoma in a Patient with Unusually Long Survival and False Negative FISH Results. Head Neck Pathol 2020; 15:698-703. [PMID: 32918711 PMCID: PMC8134642 DOI: 10.1007/s12105-020-01220-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022]
Abstract
Nuclear protein in testis (NUT) carcinoma is a rare and highly aggressive epithelial malignancy defined by rearrangement of the NUTM1 gene on chromosome 15q14. Histologically, NUT carcinoma is an undifferentiated carcinoma formed by sheets and nests of primitive and monotonous "round blue cells" with foci of abrupt keratinization in a subset. NUT carcinoma runs a fulminant clinical course and is almost always quickly lethal, with a median overall survival of only 6.7 months. There is no consensus regarding treatment for this disease, and most patients respond poorly to conventional chemotherapy and radiation. We report a case of NUT carcinoma in an African-American man who initially presented in 2009 with a tracheal mass at age 28. Although fluorescence in situ hybridization (FISH) assays for NUTM1 and BRD4 rearrangements were negative, he was diagnosed based on diffusely positive NUT immunostaining and BRD4-NUTM1 on RNA sequencing. Since his initial presentation, he has undergone multiple surgical procedures and radiation therapy. His tumor has recurred twice, but he has survived for 129 months and is currently alive without disease. Long-term survival of patients with NUT carcinoma is incredibly unusual, especially in patients with tumors that exhibit a BRD4 rearrangement. False negative FISH is a pitfall in diagnosing NUT carcinoma; NUT immunostaining and RNA sequencing are more sensitive diagnostic methods.
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Affiliation(s)
- Anne C McLean-Holden
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Samantha A Moore
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey Gagan
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christopher A French
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John M Truelson
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- UT Southwestern Medical Center, Clements University Hospital, UH04.250 6201 Harry Hines Blvd, Dallas, TX, 75390, USA.
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13
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Gondo T, Sonoo T, Hashimoto H, Nakamura K. Chemoradiation therapy for oesophageal cancer with airway stenosis under mechanical ventilation with light sedation using dexmedetomidine alone. BMJ Case Rep 2020; 13:e234507. [PMID: 32816929 PMCID: PMC7437698 DOI: 10.1136/bcr-2020-234507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2020] [Indexed: 11/04/2022] Open
Abstract
For malignant tumours, treatment is rarely indicated in cases requiring mechanical ventilation management because such intensive care would engender a decrease in performance status. However, light sedation using dexmedetomidine might enable chemoradiation while accommodating activities of daily living. We experienced two cases of fatal tracheal invasion and airway stenosis of stage Ⅳ oesophageal cancer that were treated with chemoradiation or radiation under mechanical ventilation (one case was differential lung ventilation.) with dexmedetomidine alone and rehabilitation was performed under a ventilator. Early mobilisation by light sedation with dexmedetomidine can inhibit performance status decline attributable to mechanical ventilation. Bridging tracheal intubation with light sedation by dexmedetomidine for temporary chemoradiation therapy to reduce tumour volume might present a good alternative for patients with malignant tumour.
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Affiliation(s)
- Takashi Gondo
- Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Tomohiro Sonoo
- Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Hideki Hashimoto
- Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Kensuke Nakamura
- Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
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14
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Chang HK, Chiang PJ, Lin CC, Chiou HY, Chuang ST, Chen KS, Lin YL. Pathology in Practice. J Am Vet Med Assoc 2020; 256:59-61. [PMID: 31841096 DOI: 10.2460/javma.256.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Wang Y, Cai S, Xue Q, Mu J, Gao Y, Tan F, Mao Y, Wang D, Zhao J, Gao S, He J. Treatment outcomes of patients with tracheobronchial mucoepidermoid carcinoma compared with those with adenoid cystic carcinoma. Eur J Surg Oncol 2020; 46:1888-1895. [PMID: 32418755 DOI: 10.1016/j.ejso.2020.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Tracheobronchial mucoepidermoid carcinoma (TMEC) is an extremely rare salivary gland-type neoplasm. We aimed to explore the clinical characteristics and prognosis of TMEC and to compare them with those of another rare salivary gland-type neoplasm, tracheobronchial adenoid cystic carcinoma (TACC). METHOD We performed a retrospective review of all patients pathologically diagnosed with TMEC between 1965 and 2017 at our institution. We reviewed the patients' clinical characteristics, treatment methods and outcomes and compared the results of TMEC and TACC patients. RESULTS A total of 115 consecutive patients, including 107 who underwent surgery and 8 who received nonoperative therapy, were included in our study. The 1-, 2-, and 5-year survival rates were 97.89%, 94.17%, and 90.50%, respectively, in the surgical group and 83.33%, 41.67% and 0.00%, respectively, in the nonoperative group. The multivariate analysis showed that N stage was an independent prognostic factor for overall survival (OS). TMEC patients were younger, had a shorter complaint duration, had fewer symptoms, had more bronchial tumors, and were more likely to undergo surgical treatment and achieve an R0 resection (surgically treated patients) than TACC patients; furthermore, TMEC patients had a significantly better OS than TACC patients (P < 0.050). CONCLUSIONS TMEC has different characteristics and a better prognosis than TACC, which may reflect the different biological behaviors of these two salivary gland neoplasms. Radical treatment and close follow-up are critical for surgically treated TMEC patients with lymph node metastasis.
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Affiliation(s)
- Yalong Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Songhua Cai
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Juwei Mu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Yushun Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Dali Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jun Zhao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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16
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Abstract
RATIONALE Primary schwannoma is extremely rare in the trachea, and its optimal treatment has not yet been established. Previous literature have indicated that traditional resection by thoracotomy is an effective surgical procedure but with huge trauma, and endoscopic excision is a minimally invasive surgical method but with possibility of recurrence. Window resection was usually utilized for selected patients with trachea invasion by thyroid carcinoma, but video-assisted thoracoscopic window resection for trachea schwannoma has not been reported previously. PATIENT CONCERNS A 23-year-old woman was admitted to hospital due to dyspnea, coughing and wheezing that had persisted for 2 months with aggravation for 1 week. DIAGNOSES Chest computed tomography (CT) scan revealed a well-circumscribed soft-tissue mass located on the right lateral posterior wall of the trachea. Bronchofibroscopy (BFS) showed a whitish, smooth and round mass with a wide base in the trachea. Immunohistochemical staining demonstrated cells labeled with Vim (+), S-100 (+), SOX-10 (+), SMA (-), CK (-). Histopathological examinations showed that the mass was a schwannoma. INTERVENTIONS The tumor was nearly completely excised via BFS, but relapsed 2 times at 12 days and 3 weeks after endoscopic resection. Finally, the patient underwent video-assisted thoracoscopic window resection of trachea. OUTCOMES The patient recovered rapidly and no recurrence was observed over 6 months of follow-up. LESSONS The treatment of tracheal schwannoma depends on the characteristics of tumor and the condition of patient. Surgical resection is a preferred alternative for sessile or transmural tumors and recurrence after endoscopic excision. Tracheal window resection by video-assisted thoracoscopy is beneficial for some appropriate patients with a small and sessile tumor.
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Affiliation(s)
- Huiguo Chen
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital, Sun Yat-sen University
| | - Kai Zhang
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital, Sun Yat-sen University
| | - Mingjun Bai
- Department of Vascular Interventional Radiology, the Third Affiliated Hospital, Sun Yat-sen University
| | - Haifeng Li
- Department of Pathology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jian Zhang
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital, Sun Yat-sen University
| | - Lijia Gu
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital, Sun Yat-sen University
| | - Weibin Wu
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital, Sun Yat-sen University
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17
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Ahn JH, Chung JH, Shin KC, Choi EY, Jin HJ, Choi JH, Lee KH. Mucosa-associated lymphoid tissue lymphoma of the trachea associated with idiopathic pulmonary fibrosis: A case report and literature review. Medicine (Baltimore) 2018; 97:e10727. [PMID: 29768342 PMCID: PMC5976282 DOI: 10.1097/md.0000000000010727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RATIONALE Mucosa-associated lymphoid tissue (MALT) lymphoma of the trachea is a rare disease that has been shown to be associated with chronic antigenic stimulation. There have been few reports of MALT lymphoma of the trachea in association with idiopathic pulmonary fibrosis (IPF). PATIENT CONCERNS A 73-year-old patient visited with a 2-year history of dyspnea on exertion and productive cough, which had worsened 1 month ago. DIAGNOSES MALT lymphoma of the trachea associated with IPF. INTERVENTIONS After taking into consideration the age, poor performance status, and comorbidities of the patient and the extent of disease, we utilized an observational approach as a treatment strategy. OUTCOMES The patient is well without any evidence of progression for 12 months since the initial diagnosis. LESSONS We present a case of MALT lymphoma of the trachea associated with IPF. A common predisposing factor may exist for tracheal MALT lymphoma and IPF. As there are no randomized clinical trials focusing on tracheal MALT lymphoma, individualized treatment decision is important, and in some cases, simply monitoring the patient might be the most appropriate approach.
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Affiliation(s)
| | | | | | | | | | - Joon Hyuk Choi
- Department of Pathology, Regional Center for Respiratory Disease, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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18
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Abstract
RATIONALE Glomus tumors (GTs) are rare soft tissue neoplasms. Several treatment options have been reported for tracheal GTs including thoracotomy, bronchoscopic electrocautery, Nd: YAG laser, and cryotherapy. However, few studies have evaluated the ideal treatment for tracheal GTs. PATIENT CONCERNS A 30-year old man who presented with cough, and expectoration for 1 month, and who had been diagnosed as having a tracheal neoplasm by cervical, and thoracic computed tomography (CT). The patient was a47 years old man. He was admitted to our hospital presenting with intermittent hemoptysis for 3 years. Thoracic CT revealed a round tumor on the right posterior tracheal wall. DIAGNOSES Both of them were diagnosed as benign GTs. Histopathology of the tumor showed clusters of round epithelioid cells with eosinophilic cytoplasm, and uniform round to ovoid nuclei surrounding dilated capillaries. Immunohistochemical staining was positive for smooth muscle actin (SMA). INTERVENTIONS The tracheal tumor of first patient was located at the level of C7-T1. Tumor resection was performed under fiberoptic bronchoscopy. The tracheal tumor in second patient was located in the lower trachea. Surgical tracheal resection and anastomosis were performed. OUTCOMES Both of them achieved good results and no recurrence was seen at the final follow-up LESSONS:: We recommend choosing the most appropriate approach to manage tracheal GTs based on patients' general condition, and tumor characteristics to obtain an excellent prognosis. Our 2 cases of tracheal GT were managed by different approaches, and both achieved good results.
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Affiliation(s)
- Li Guo
- Department of Respiratory and Critical Care Medicine
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine
| | - Hui Zhu
- Department of Respiratory and Critical Care Medicine
| | | | - Daxing Zhu
- Department of Thoracic Sugery, Sichuan University, West China Hospital, Chengdu, China
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19
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Zhang Y, Xin J, Ma Y, Li Q, Liu B. Use of Univent tube for intermittent lung isolation during thoracoscopic mediastinal tracheal resection and reconstruction: A case report. Medicine (Baltimore) 2017; 96:e8945. [PMID: 29390285 PMCID: PMC5815697 DOI: 10.1097/md.0000000000008945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Primary tracheal adenoid cystic carcinoma of the trachea primary is a rare neoplasm and commonly misdiagnosed. Lung isolation during surgery and ventilation pose a tremendous challenge to anesthesiologists. PATIENT CONCERNS The authors describe a novel technique of lung isolation and ventilation with a Univent tube during thoracoscopic mediastinal tracheal resection and reconstruction in a female patient. DIAGNOSES Primary tracheal adenoid cystic carcinoma, nonsmall cell carcinoma. INTERVENTIONS In this case, tracheal resection and reconstruction were performed. A bronchial blocker of the Univent tube was used as a guide to manipulate the depth of endotracheal tube. OUTCOMES The intermittent 1-lung ventilation was established successfully. The patient recovered uneventfully and discharged after 10 days. LESSONS The advantages of approach include a stable airway management without occupying the contracted space of thoracoscope and no potential risk of trapping or barotraumas.
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20
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Cho HJ, Yoon J, Lee E, Lee YS, Kim SY, Roh JL, Kim DK, Choi SH, Park SI, Kim YH, Koh KN, Im HJ, Seo JJ, Hong SJ, Yu J. The Different Clinical Aspects of Pediatric Primary Airway Tumors in the Larynx, Trachea, and Bronchi. J Korean Med Sci 2017; 32:1304-1311. [PMID: 28665067 PMCID: PMC5494330 DOI: 10.3346/jkms.2017.32.8.1304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/18/2017] [Indexed: 01/31/2023] Open
Abstract
Primary airway tumors are rare in children and no literature reviewed their characteristics each location. We evaluate the clinical characteristics and outcomes of Korean children with primary airway tumors, from the larynx to bronchi. A retrospective chart review of children with primary tumors of the larynx, trachea, and bronchi at Asan Medical Center from January 2000 to July 2016 was conducted. Nineteen children were diagnosed with primary airway tumors of the larynx (47.4%), trachea (10.5%), and bronchi (42.1%). Median follow-up duration was 2.8 years and there were recurrences in 21.1%. Laryngeal tumors were associated with a younger median age at onset (2 months) and diagnosis (4 months), and most were relatively small (median size = 5.3 mm) and symptomatic. Tracheal and bronchial tumors were found in older children (age at onset and diagnosis > 11 years) and large (> 15.0 mm). Most (75%) patients with bronchial tumors were asymptomatic and all the patients with tracheal tumors were symptomatic. This study suggests that we should consider different the locations in primary airway tumor based on the age at onset and diagnosis, initial symptoms or signs, and size of tumor.
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Affiliation(s)
- Hyun Ju Cho
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jisun Yoon
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
| | - Yoon Se Lee
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong Lyel Roh
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Se Hoon Choi
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Il Park
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yong Hee Kim
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung Nam Koh
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Ho Joon Im
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Jong Jin Seo
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Soo Jong Hong
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jinho Yu
- Division of Pediatric Allergy and Respiratory, Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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21
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Abstract
RATIONALE Primary clear cell carcinoma of the lung is a rare condition, and presentation as an endotracheal lesion is even more unusual. In this report, we present a patient with clear cell carcinoma occurring in the trachea, which obstructed the tracheal lumen and lead to the respiratory distress. PATIENT CONCERNS A 60-year old female patient was admitted due to a 6-month history of dyspnea with worsening symptoms for 1 month. Chest CT scan revealed a smooth nodular shadow with homogeneous density on the wall of upper trachea. DIAGNOSIS Bronchoscopy therapy and surgical removal of the tumor were performed. The histopathological diagnosis revealed clear cell carcinoma. INTERVENTION Surgical removal of the clear cell carcinoma was performed. OUTCOMES The patient recovered well after the surgery and is now being followed-up after hospital discharge. LESSONS Bronchoscopy is an essential tool for diagnosis of tracheal clear cell carcinoma. Surgical removal should be performed if possible.
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Affiliation(s)
- Min Li
- Department of Respiratory Medicine
| | - Wenye Zhu
- Department of Pharmacy, First Affiliated Hospital of Kunming Medical University
| | | | - Ummair Saeed
- Postgraduate School of Kunming Medical University, Kunming, Yunnan, P.R. China
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22
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Le Boedec K, Phillips H, Zamprogno H, Joslyn S, O'Brien RT, Lezmi S. Pathology in Practice. J Am Vet Med Assoc 2017; 250:993-995. [PMID: 28414594 DOI: 10.2460/javma.250.9.993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Vallonthaiel AG, Jain D, Singh V, Kaur K, Madan K, Kumar V, Iyer VK, Sharma MC. c-Myb Overexpression in Cytology Smears of Tracheobronchial and Pulmonary Adenoid Cystic Carcinomas. Acta Cytol 2016; 61:77-83. [PMID: 27974718 DOI: 10.1159/000453103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/02/2016] [Indexed: 12/13/2022]
Abstract
AIMS Adenoid cystic carcinoma (AdCC) is a malignant epithelial neoplasm that occurs rarely in the lower respiratory tract (LRT). AdCC at various sites is associated with the novel fusion transcript MYB-NFIB, along with the overexpression of the Myb protein. The expression of the Myb protein in AdCC of the LRT has not been evaluated much. STUDY DESIGN Cases of AdCC of the LRT diagnosed on cytology or histology were retrieved from our institutional archives. c-Myb expression was analyzed on immunocytochemistry/immunohistochemistry (ICC/IHC) and was correlated with clinicopathological parameters. RESULTS Twenty-three samples of AdCC originating from the LRT were included in the study. Four cases were diagnosed on cytology, 3 of which had corresponding histology specimens. The remaining 19 cases had either biopsy or resection. Most of the patients presented with endobronchial mass. The mean age was 49.4 years and a male predominance was seen. ICC and IHC for c-Myb showed positivity in 75 and 59% of the cases, respectively. Western blot was used to validate IHC results. CONCLUSION AdCC of the LRT is rare and hence poses diagnostic difficulty. Cytology smears can be utilized for c-Myb ICC. The presence of c-Myb immunopositivity in most cases may possibly make Myb a diagnostic biomarker and a therapeutic target for personalized treatment.
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24
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Öztürk A, Aktaş Z, Yılmaz A, Yeşildağlı H, Memiş L. A case of tracheal leiomyoma misdiagnosed as asthma. Tuberk Toraks 2016; 64:306-309. [PMID: 28393719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum. In computed tomography, a lesion has been detected in proximal trachea, arising from the posterior wall and protruding through the lumen and almost obliterating the air column. Rigid bronchoscopy has been performed under general anesthesia due to a high risk of bleeding and the endobronchial lesion, freely moving with respiration, has been removed and cryotherapy was applied to the base of the lesion. Receiving the histopathological diagnosis of leiomyoma, the patient is now on 12th month of the follow-up without any recurrence.
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Affiliation(s)
- Ayperi Öztürk
- Clinic of Interventional Pulmonology Ankara Ataturk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey.
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25
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Affiliation(s)
- Peter G Michaelson
- Department of Otolaryngology-Head and Neck Surgery, Wilford Hall USAF Medical Center, San Antonio, TX 78236-5300, USA.
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26
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Abstract
OBJECTIVE: Determine staging characteristics and survival outcomes for primary malignancies of the trachea. DESIGN: Cross-sectional analysis of national cancer database. METHODS: Cases of primary tracheal malignancy were extracted from the Surveillance, Epidemiology, and End Results database for the time period 1988-2000. T-stage, N-stage, and overall stage of presentation were determined. Mean, median, and 5-year survival statistics were computed using Kaplan-Meier survival analysis for each tumor histology and for the overall cohort according to stage. RESULTS: Ninety-two cases with adequate histologic information were identified. Mean age at presentation was 59.3 years with an equal sex distribution. Squamous cell carcinoma was the most common tumor type (41 cases) followed by adenoid cystic carcinoma (19 cases). Forty-nine cases (53%) presented with stage 3 or stage 4 disease. Squamous cell carcinoma exhibited poorer survival (mean survival, 44.0 month, 5-year survival, 34%) than adenoid cystic carcinoma (mean survival, 115 month, 5-year survival, 78%). Five-year unadjusted survival rates according to overall stage were 52.8%, 70.0%, 75.0%, 15.1%, respectively. CONCLUSIONS: Primary tracheal malignancies often present with advanced stage. Patients with squamous cell carcinoma of the trachea have poorer prognoses when compared with adenoid cystic carcinoma and other tumor types. Staging tracheal cancer with a TNM-based system helps predict survival. EBM rating: C.
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Affiliation(s)
- Neil Bhattacharyya
- Department of Otology and Laryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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27
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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. Rev Port Pneumol (2006) 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] [What about the content of this article? (0)] [Affiliation(s)] [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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28
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Lee DH, Yoon TM, Lee JK, Lim SC. Unusual Granular Cell Tumor of the Trachea Coexisting With Papillary Thyroid Carcinoma and Masquerading as Tracheal Invasion of Recurred Thyroid Carcinoma: A Case Report. Medicine (Baltimore) 2016; 95:e3547. [PMID: 27149467 PMCID: PMC4863784 DOI: 10.1097/md.0000000000003547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This was an extremely rare case of unusual granular cell tumor of the trachea coexisting with recurrent papillary thyroid carcinoma. We initially misdiagnosed this patient as having tracheal invasion from recurrent thyroid carcinoma even after a computed tomography scan and fine-needle aspiration cytology.Clinicians should be aware of the possibility of granular cell tumor of the trachea occurring simultaneously with papillary thyroid carcinoma.
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Affiliation(s)
- Dong Hoon Lee
- From the Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
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Hawley MM, Johnson LR, Johnson EG, Pascoe PJ, Murphy BG. Endoscopic treatment of an intrathoracic tracheal osteochondroma in a dog. J Am Vet Med Assoc 2015; 247:1303-8. [PMID: 26594814 DOI: 10.2460/javma.247.11.1303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 1.5-year-old spayed female Bernese Mountain Dog was examined for a 6-month history of intermittent vomiting, regurgitation, wheezing, and coughing. Initially, a diagnosis of gastroesophageal reflux disease with secondary aspiration pneumonitis was made but clinical signs did not resolve with treatment. CLINICAL FINDINGS Thoracic and cervical radiography and CT revealed a sessile, irregularly marginated soft tissue opacity at the level of the fourth rib. Results of a CBC, serum biochemical analysis, and urinalysis were within reference limits. Results of abdominal ultrasonography were normal. TREATMENT AND OUTCOME Tracheoscopy revealed a firm, irregularly marginated mass apparently originating from the ventral aspect of the trachea, occluding approximately one-half of the tracheal lumen, and located 2 cm cranial to the carina. Cytologic and histopathologic examination of fine-needle aspirate and biopsy samples suggested a benign etiology; therefore, endoscopic minimally invasive laser and electrocautery resection of the mass was scheduled. A total IV anesthetic protocol was administered with an oxygen-air mixture used to decrease the risk of fire during tracheal surgery. The mass was successfully resected, and histopathologic examination confirmed a diagnosis of osteochondroma. Clinical signs resolved, and at follow-up 32 months later, no regrowth of the mass was evident. CLINICAL RELEVANCE Tracheoscopy-guided electrocautery and surgical diode laser resection was successful in removing an obstructive tracheal mass that was not resectable by means of a conventional open surgical approach. Minimally invasive procedures may decrease morbidity and mortality and improve outcome in appropriately selected small animal patients.
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Luo M, Duan C, Qiu J, Li W, Zhu D, Cai W. Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors. PLoS One 2015; 10:e0137329. [PMID: 26332466 PMCID: PMC4558050 DOI: 10.1371/journal.pone.0137329] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/16/2015] [Indexed: 12/25/2022] Open
Abstract
Purpose To evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors. Methods Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology. Results Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm—56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm—68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without obvious enhancement, n = 1). Conclusion MDCT and its MPR, VR and VB images have respective advantages and disadvantages. Their combination could complement to each other to accurately detect locations, natures (benignancy, malignancy or low malignancy), and quantities (extramural invasions, longitudinal involvements, extents of luminal stenoses, distances between main bronchus tumors and trachea carinae) of primary trachea and main bronchus tumors with crucial information for surgical treatment, are highly useful diagnostic methods for primary trachea and main bronchus tumors.
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Affiliation(s)
- Mingyue Luo
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail:
| | - Chaijie Duan
- Research Center of Biomedical Engineering, Graduate School at Shenzhen, Tsinghua University, Shenzhen, Guangdong, China
| | - Jianping Qiu
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenru Li
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Dongyun Zhu
- Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenli Cai
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
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Wang H, Xie J, Tan Y, Jiang J. Glomus tumor of the trachea: a rare case report. Int J Clin Exp Pathol 2015; 8:9723-9726. [PMID: 26464745 PMCID: PMC4583977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 07/26/2015] [Indexed: 06/05/2023]
Abstract
A tracheal glomus tumor is extremely rare. There were approximately 18 reported cases before in China. Here we report a 48-year-old male with glomus tumor of the trachea. The computed tomography (CT) scan of the chest showed a nodulein the basalsegmentof right lower lobe, focal uplift in the left-posterior wall of the trachea, measured 1.5×1.2×1.0 cm. Microscopically, the tumor tissue was rich with vessels, shaped flake-nest, and the tumor consisted of a sheet of uniform cells surrounding the vascular spaces. Immumohistochemical staining were positive for SMA, vimentin, collagen IV, CD34, the Ki-67 proliferation activity was low (<1%), and were negative for Syn, CgA, S-100, AE1/AE3 and EMA. PSA staining showing clear cell borders. With a review of the literature, the clinical, pathological characteristics and treatment modalities of this rare tumor are discussed.
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Affiliation(s)
- Hui Wang
- Department of Pathology, The Third Affiliated Hospital of Soochow University185 Juqian Street, Changzhou 213003, P. R. China
| | - Jun Xie
- Department of Pathology, The Third Affiliated Hospital of Soochow University185 Juqian Street, Changzhou 213003, P. R. China
| | - Yan Tan
- Department of Pathology, The Third Affiliated Hospital of Soochow University185 Juqian Street, Changzhou 213003, P. R. China
| | - Jingting Jiang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow UniversityChangzhou 213003, P. R. China
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Qiu J, Lin W, Zhou ML, Zhou SH, Wang QY, Bao YY. Primary small cell cancer of cervical trachea: a case report and literature review. Int J Clin Exp Pathol 2015; 8:7488-7493. [PMID: 26261658 PMCID: PMC4525992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 05/28/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED Primary small cell carcinoma of trachea is even more uncommon and only a few cases have been reported. Our search revealed only 90 cases in the English-language literatures. CASE REPORT we report a case of cervical tracheal small cell cancer. A 67-year-old male presented with over 2-month history of cough and dyspnea. CT and MRI revealed a 1.0 cm × 2.5 cm intraluminal, irregular soft tissue mass in the upper trachea, approximately 2.5 cm below the glottis. A bronchoscopic examination disclosed a large tumor in the cervical trachea and the lesion occupied more than 60% of the tracheal lumen. Cytological examination suggested some poorly differentiated carcinoma cells. The patient received concurrent chemoradiotherapy and did not perform surgery. One week after CCR, the patient occurred difficulty in breath and tracheal stent was implanted. The symptom was improved markedly. Four days after implant of tracheal stent, the patient presented irritable cough and hemoptysis. The amount of bleeding was about 300 ml. The hemorrhage stopped by treatment of vasoconstrictor and fresh plasma. However, two days later, hemoptysis was continuing even if treatment of vasoconstrictor and fresh plasma. The patient and relatives waived the further therapies. The patient died of massive hemoptysis one week out of hospital. CONCLUSIONS The tracheal small cell cancer is rare. The optimal treatment is unclear. In general, the strategy is introduced concurrent chemoradiotherapy following as small cell lung cancer. In cervical trachea, we suggest that surgical resection should be performed followed by postoperative adjuvant therapy.
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Affiliation(s)
- Jun Qiu
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
- Now Working at Department of Otolaryngology, The People’s Hospital of Zhejiang Province310014, China
| | - Wei Lin
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Min-Li Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Qin-Ying Wang
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
| | - Yang-Yang Bao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University310003, China
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Terada Y, Murakawa T, Kitano K, Murayama T, Ichinose J, Hino H, Nagayama K, Nitadori JI, Anraku M, Nakajima J. [Tracheal Resection and Reconstruction for a Squamous Cell Carcinoma of the Trachea;Report of a Case]. Kyobu Geka 2015; 68:473-475. [PMID: 26066883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report a case of tracheal resection and reconstruction for a squamous cell carcinoma of the trachea that was found in an 82-year-old male patient who had underwent right lower lobectomy for an adenosquamous cell carcinoma 3.5 years before. He noticed bloody sputum. Chest computed tomography (CT) revealed a 15 mm tumor in the anterior wall of the trachea. A transbronchial biopsy for the tracheal tumor showed a squamous cell carcinoma. Under right thoracotomy, we resected the tumor with 3 tracheal rings. Histologically a squamous cell carcinoma was diagnozed. As there was intraepithelial spread of cancer cells in the oral margin, the tracheal tumor was suspected to be a primary tracheal tumor rather than a metastasis from lung cancer. After the surgery, combination therapies of an external radiation therapy for 50 Gy and brachytherapy 2 times for totally 8 Gy were performed as a postoperative adjuvant therapy. He does not have any signs of recurrence in 1 year and 6 months after the surgery.
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Affiliation(s)
- Yuriko Terada
- Department of Thoracic Surgery, The University of Tokyo, Tokyo, Japan
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34
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Liu L, Yan Z, Tao S. [Pleomorphic adenoma of the trachea: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 50:425-426. [PMID: 26178060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
Multiple or second primary lung cancers can develop at any sites in the lung with same or different histologic types, synchronously and/or metachronously. In case of metachronous occurrence of the second primary lung cancer, it is easy to confuse with the primary lung cancer as a recurrence of precedent lung malignancy treated successfully or metastasis. Previous reports have demonstrated that majority of the second primary lung malignancies have same histologic types regardless of their developing time and location. However, the repeated occurrence of the second primary lung malignancy, in particular with the different histologic features, is a very rare condition.A 62-year-old male who had past history of squamous cell carcinoma treated with surgery and adjuvant chemotherapy and the recurrence of lung malignancy on the trachea, which was also resected successfully visited our hospital due to blood tinged sputum. Evaluation using bronchoscopy and chest computed tomography revealed the tracheal mass looked similar grossly to the previous recurred tracheal mass that was resected surgically. Unexpectedly, the newly developed tracheal mass was confirmed as small cell lung cancer, the different histologic type from previous ones.In this report, we describe an interesting case of subsequent occurrence of second primary lung cancers showing histologic shifting at different sites in trachea, suggesting that it is important for physician to make an effort to identify the histologic characteristics of second primary lung cancers for the correct and adequate treatment no matter what they exhibit similar gross morphology.
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Affiliation(s)
- Yong Chul Lee
- From the Department of Internal Medicine and Research Center for Pulmonary Disorders (YCL, YJP, SJG, SRK); Department of Pathology, Chonbuk National University Medical School (MJC); and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea (YCL, MJC, SRK)
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Craighead JE, Mossman BT. Carcinoma induction by 3-methylcholanthrene in hamster tracheal tissue implanted in syngeneic animals. Prog Exp Tumor Res 2015; 24:48-60. [PMID: 538263 DOI: 10.1159/000402083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Grubbs CJ, Moon RC, Norikane K, Thompson HJ, Becci PJ. 1-methyl-1-nitrosourea induction of cancer in a localized area of the Syrian golden hamster trachea. Prog Exp Tumor Res 2015; 24:345-55. [PMID: 538254 DOI: 10.1159/000402110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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39
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Alfaro TM, Nazareth C, Robalo-Cordeiro C. [Endotracheal Kaposi's Sarcoma]. ACTA MEDICA PORT 2015; 28:267. [PMID: 26061520 DOI: 10.20344/amp.5237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 05/05/2014] [Indexed: 11/20/2022]
Abstract
<strong>Keywords:</strong> HIV Infections; Sarcoma, Kaposi; Trachea.
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Affiliation(s)
- Tiago M Alfaro
- Centro de Pneumologia. Universidade de Coimbra. Coimbra. Portugal. Serviço de Pneumologia A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Cláudia Nazareth
- Serviço de Doenças Infeciosas. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Carlos Robalo-Cordeiro
- Centro de Pneumologia. Universidade de Coimbra. Coimbra. Portugal. Serviço de Pneumologia A. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
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40
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Abdennadher M, Rivera C, Gibault L, Fabre E, Pricopi C, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F, Riquet M. [Mucoepidermoid tracheo-bronchial tumors in adulthood. A series of 22 cases]. Rev Pneumol Clin 2015; 71:27-36. [PMID: 25687822 DOI: 10.1016/j.pneumo.2014.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/18/2014] [Accepted: 09/21/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Mucoepidermoid tumours (TME) are rare tumours arising from the submucosal glands of the tracheobronchial tree. The majority of these tumours develop in a benign fashion but some of them are malignant. The latter can be easily mistaken for adenosquamous carcinomas. PATIENTS AND METHOD We have reviewed 22 patients suffering from TME observed over a period of 25 years. Two arose from the trachea and 20 from the cartilaginous bronchi; 12 of these tumours had macroscopic and histological criteria of low-grade malignancy, 4 had macroscopic and 6 macroscopic and microscopic criteria of high grade malignancy. RESULTS Prognosis of the latter was very poor and no survival observed after 6 years follow-up, a behavior similar to that observed in non-small cell lung carcinomas and adenosquamous carcinomas. CONCLUSION The best treatment of these orphan tumours remains surgery.
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Affiliation(s)
- M Abdennadher
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - C Rivera
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - L Gibault
- Service d'anatomie pathologique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - E Fabre
- Service d'oncologie, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - C Pricopi
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - A Arame
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - C Foucault
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - A Dujon
- Service de chirurgie thoracique, centre médico-chirurgical du Cèdre, 76230 Bois Guillaume, France
| | - F Le Pimpec Barthes
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France
| | - M Riquet
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France.
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Borik W, Pricopi C, Hernigou A, Fabre E, Laccourreye O, Hidden G, Le Pimpec Barthes F, Riquet M. [Squamous cell carcinoma of the trachea: imaging lymph node mapping]. Rev Pneumol Clin 2014; 70:329-334. [PMID: 25457221 DOI: 10.1016/j.pneumo.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/17/2014] [Indexed: 06/04/2023]
Abstract
The anatomy of the trachea lymphatics is poorly understood and the only researches date back to more than one century. Tracheal tumors are very rare, miscellaneous and variously lymphophilic. The cancers of the trachea have no TNM and their lymph node metastases are little studied despite their poor prognosis. We observed 2 cases of squamous cell carcinoma, one in the cervical and the other in the intrathoracic trachea. TDM-3D reformats demonstrated metastatic lymph nodes of the right para-tracheal lymph node chain (2R and 4R) in both patients and in the cervical lymph nodes (right recurrent nerve lymph node chain) in the patient with cervical tumor. Right location of the mediastinal metastases may be explained by the anatomy of the lymph node chain drainage of the lung segments, the right para-tracheal chain being the only one to regularly possess lymph nodes at that level. The right recurrent nerve lymph node metastases of the cervical tumor are explained by common lymph drainage of the cervical trachea towards larynx lymph centres. Besides lymph node metastases, cancers prognosis may also depends on its location in the trachea. Thus, the tracheal tumors are complex and constitute quite as many orphan tumors. Multicentric studies are mandatory to better understand their behavior. Means provided by new imaging techniques might permit establishing a veritable TNM lymph node mapping of these tumors.
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Affiliation(s)
- W Borik
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - C Pricopi
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - A Hernigou
- Service de radiologie, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - E Fabre
- Service d'oncologie médicale, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - O Laccourreye
- Service d'ORL, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - G Hidden
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - F Le Pimpec Barthes
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France
| | - M Riquet
- Service de chirurgie thoracique, hôpital européen Georges-Pompidou, université Paris Descartes, 20-40, rue Leblanc, 75015 Paris, France.
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Ayadi-Kaddour A, Khadhar A, Mlika M, Ismail O, Braham E, Marghli A, Zidi A, El Mezni F. [Tracheal tumor treated as asthma]. Rev Pneumol Clin 2014; 70:353-356. [PMID: 25131369 DOI: 10.1016/j.pneumo.2014.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/28/2014] [Accepted: 04/03/2014] [Indexed: 06/03/2023]
Abstract
Primary tumors of the trachea are very rare. In adults, the majority of them are malignant. Schwannomas are exceedingly rare benign tumors in the tracheobronchial tree. We report a case of a 37-year-old man who was hospitalized for increasing dyspnea. He had been treated for bronchial asthma for the last 4 years with no benefit. The CT scan of the chest and bronchoscopy identified a tracheal mass that was prolapsed in the left stem bronchus. The patient did not remain free of disease after endoscopic laser resection. So, surgical resection was made. The tumor was excised at its base. A segment of the left stem bronchus was removed and primary anastomosis was performed. The histopathologic diagnosis was of a benign schwannoma without malignant elements. There was no recurrence during the follow-up period. This case demonstrates that intratracheal masses should be considered in patients with dyspnea or in patients with asthma refractory to conventional therapy.
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Affiliation(s)
- A Ayadi-Kaddour
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie.
| | - A Khadhar
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - M Mlika
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - O Ismail
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - E Braham
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - A Marghli
- Service de chirurgie thoracique, hôpital Abderrahmen Mami, Ariana, Tunisie
| | - A Zidi
- Service de radiologie, hôpital Abderrahmen Mami, Ariana, Tunisie
| | - F El Mezni
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
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Liu H, Li Z, Dong H, Leng H, Sun H, Li S. [Surgical treatment and reconstruction of thyroid carcinoma invading cervical esophagus and trachea full-thickness]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1927-1930. [PMID: 25895307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To summary the clinical therapy experience of thyroid carcinoma invading cervical esophagus and trachea full thickness and reconstruction of them to improve the survival rate and quality of life of these patients. METHOD In 33 patients with thyroid carcinoma inviding cervical esophagus and trachea, 7 patients were operated with total thyroid resection, 22 patients were operated with one lobectomy and the other side subtotal thyroid resection,and 4 patients were operated with partial lobectomy. Trachea local recection and intubation were performed on 19 patients, partial laryngectomy and pyriform sinus resection with trachea local recection and intubation were performed on 4 patients,and 10 cases were operated with tracheal sleeve resection and end to end anastomos. RESULT All patients were primary healing without tracheal anastomosis fistula, tracheal wall necrosis, esophageal fistula and pharyngeal fistula. One case had hypoparathyroidism after the operation and took a favorable turn a month later. Seven cases were dead (21. 21%). 1-year, 3-year, 5-year survival rates of the thyroid papillary carcinoma inviding cervical esophagus and trachea were 100.0%, 93.8% and 70.3%; 1-year, 3-year, 5-year survival rates of the thyroid carcinoma inviding cervical esophagus and trachea were 96.6%, 79.0% and 61.4%. CONCLUSION Thyroid carcinoma invading cervical esophagus and trachea full-thickness can be treated with surgical methods, and tracheal sleeve resection and end to end anastomos are the suitable methods.
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Huo Z, Meng Y, Wu H, Shen J, Bi Y, Luo Y, Cao J, Liang Z. Adenoid cystic carcinoma of the tracheobronchial tree: clinicopathologic and immunohistochemical studies of 21 cases. Int J Clin Exp Pathol 2014; 7:7527-7535. [PMID: 25550788 PMCID: PMC4270623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 10/16/2014] [Indexed: 06/04/2023]
Abstract
AIMS To review retrospectively 21 cases adenoid cystic carcinoma of the tracheobronchial tree (TACC) with emphasis on their clinical and pathologic features, treatment and the possible prognostic factors. METHODS AND RESULTS 21 cases TACC diagnosed by surgical biopsy or resection at the Peking Union Medical College Hospital (PUMCH) over 10 years. Patients aged 24-69 years (median, 49 years), 6 men/15 women. Cough (18/21), dyspnea (14/21) and hemoptysis (10/21) were the most frequent manifestations. 15 patients had tumors in trachea. Ten patients had pathologically positive margin (n = 11). Immunohistochemically, BCL-2, CD117, P16, type IV collagen, SMA and P63 were positive (20/20); GFAP was focally positive (4/20); TTF-1 and P53 were negative (0/20). Ki-67 index ranged from 2% to 35%. Fifteen patients had followed up, 13 of which received postoperative radiotherapy. The median relapse-free survival (RFS) was 56.9 months and the 5-year RFS was 48.6%. By univariate analysis, postoperative radiotherapy had favorable prognostic significance (P < 0.05). CONCLUSIONS TACC, which is mainly located in primary trachea or bronchus, is difficult to be detected at early stage. The tumors are not likely to be completely removed by surgery, and postoperative radiotherapy is helpful for reducing the likelihood of recurrence and metastasis.
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Affiliation(s)
- Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Yunxiao Meng
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Huanwen Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Jie Shen
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Yalan Bi
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Yufeng Luo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Jinling Cao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730, China
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Xu L, Zhang S, Li J, Liu J, Liu H, Huang W, Shang X. Human tracheal allotransplant with greater omentum for revascularization. EXP CLIN TRANSPLANT 2014; 12:448-453. [PMID: 25299372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Human tracheal allotransplant is an option for treating long-segment tracheal defects, but no reliable and satisfactory tracheal transplant procedure has been developed. The purpose of this study is to review the results of 2-stage tracheal reconstruction in human tracheal allotransplant for tracheal defects > 5 cm with the use of greater omentum for revascularization. MATERIALS AND METHODS There were 3 patients who had tracheal allograft. In stage 1, a segment of donor trachea (6 cm) was excised and wrapped in the recipient greater omentum. In stage 2, at 3 to 5 weeks after stage 1, the tracheal allograft and omental pedicle were orthotopically transplanted to the cervical part of the trachea. All patients received immunosuppression with tacrolimus, mycophenolate mofetil, and methylprednisolone. Fiberoptic bronchoscopy was performed monthly during the 6 months after stage 2. RESULTS In all 3 patients, no major postoperative complication was observed. Transverse section of the donor trachea showed a mechanically stable chondral framework. Histologic sections stained with hematoxylin-eosin showed complete cartilage rings covered by intact respiratory epithelium. CONCLUSIONS A 2-stage procedure for human tracheal transplant with greater omentum is a safe and effective technique for tracheal reconstruction.
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Affiliation(s)
- Lin Xu
- From the Department of Thoracic Surgery, The First Hospital of Peking University, Beijing, China
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Lim ML, Ooi BNS, Jungebluth P, Sjöqvist S, Hultman I, Lemon G, Gustafsson Y, Asmundsson J, Baiguera S, Douagi I, Gilevich I, Popova A, Haag JC, Rodríguez AB, Lim J, Liedén A, Nordenskjöld M, Alici E, Baker D, Unger C, Luedde T, Vassiliev I, Inzunza J, Ährlund-Richter L, Macchiarini P. Characterization of stem-like cells in mucoepidermoid tracheal paediatric tumor. PLoS One 2014; 9:e107712. [PMID: 25229469 PMCID: PMC4167860 DOI: 10.1371/journal.pone.0107712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 08/14/2014] [Indexed: 02/06/2023] Open
Abstract
Stem cells contribute to regeneration of tissues and organs. Cells with stem cell-like properties have been identified in tumors from a variety of origins, but to our knowledge there are yet no reports on tumor-related stem cells in the human upper respiratory tract. In the present study, we show that a tracheal mucoepidermoid tumor biopsy obtained from a 6 year-old patient contained a subpopulation of cells with morphology, clonogenicity and surface markers that overlapped with bone marrow mesenchymal stromal cells (BM-MSCs). These cells, designated as MEi (mesenchymal stem cell-like mucoepidermoid tumor) cells, could be differentiated towards mesenchymal lineages both with and without induction, and formed spheroids in vitro. The MEi cells shared several multipotent characteristics with BM-MSCs. However, they displayed differences to BM-MSCs in growth kinectics and gene expression profiles relating to cancer pathways and tube development. Despite this, the MEi cells did not possess in vivo tumor-initiating capacity, as proven by the absence of growth in situ after localized injection in immunocompromised mice. Our results provide an initial characterization of benign tracheal cancer-derived niche cells. We believe that this report could be of importance to further understand tracheal cancer initiation and progression as well as therapeutic development.
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Affiliation(s)
- Mei Ling Lim
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | | | - Philipp Jungebluth
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Sjöqvist
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Isabell Hultman
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Greg Lemon
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Ylva Gustafsson
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Jurate Asmundsson
- Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Silvia Baiguera
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Iyadh Douagi
- Center for Hematology and Regenerative Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Irina Gilevich
- International Scientific-Research Clinical and Educational Center of Regenerative Medicine, Kuban State Medical University, Krasnodar, Russian Federation
| | - Alina Popova
- International Scientific-Research Clinical and Educational Center of Regenerative Medicine, Kuban State Medical University, Krasnodar, Russian Federation
| | - Johannes Cornelius Haag
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Antonio Beltrán Rodríguez
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Jianri Lim
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
| | - Agne Liedén
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Nordenskjöld
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Evren Alici
- Center for Hematology and Regenerative Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Duncan Baker
- Department of Biomedical Sciences, University of Sheffield, Sheffield, United Kingdom
| | - Christian Unger
- Department of Biomedical Sciences, University of Sheffield, Sheffield, United Kingdom
| | - Tom Luedde
- Department of Medicine III, University Hospital RWTH Aachen, Germany
| | - Ivan Vassiliev
- Robinson Institute, Center for Stem Cell Research, The University of Adelaide, Adelaide, Australia
| | - Jose Inzunza
- Department of Biosciences and Nutrition, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Lars Ährlund-Richter
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Macchiarini
- Advanced Center for Translational Regenerative Medicine, Department for Clinical Science, Intervention and Technology, Division of Ear, Nose, Throat, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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Pipinikas CP, Kiropoulos TS, Teixeira VH, Brown JM, Varanou A, Falzon M, Capitanio A, Bottoms SE, Carroll B, Navani N, McCaughan F, George JP, Giangreco A, Wright NA, McDonald SAC, Graham TA, Janes SM. Cell migration leads to spatially distinct but clonally related airway cancer precursors. Thorax 2014; 69:548-57. [PMID: 24550057 PMCID: PMC4033139 DOI: 10.1136/thoraxjnl-2013-204198] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 01/09/2014] [Accepted: 01/24/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Squamous cell carcinoma of the lung is a common cancer with 95% mortality at 5 years. These cancers arise from preinvasive lesions, which have a natural history of development progressing through increasing severity of dysplasia to carcinoma in situ (CIS), and in some cases, ending in transformation to invasive carcinoma. Synchronous preinvasive lesions identified at autopsy have been previously shown to be clonally related. METHODS Using autofluorescence bronchoscopy that allows visual observation of preinvasive lesions within the upper airways, together with molecular profiling of biopsies using gene sequencing and loss-of-heterozygosity analysis from both preinvasive lesions and from intervening normal tissue, we have monitored individual lesions longitudinally and documented their visual, histological and molecular relationship. RESULTS We demonstrate that rather than forming a contiguous field of abnormal tissue, clonal CIS lesions can develop at multiple anatomically discrete sites over time. Further, we demonstrate that patients with CIS in the trachea have invariably had previous lesions that have migrated proximally, and in one case, into the other lung over a period of 12 years. CONCLUSIONS Molecular information from these unique biopsies provides for the first time evidence that field cancerisation of the upper airways can occur through cell migration rather than via local contiguous cellular expansion as previously thought. Our findings urge a clinical strategy of ablating high-grade premalignant airway lesions with subsequent attentive surveillance for recurrence in the bronchial tree.
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Affiliation(s)
| | - Theodoros S Kiropoulos
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Department of Respiratory Medicine, University of Thessaly School of Medicine, Larissa, Greece
| | - Vitor H Teixeira
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - James M Brown
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Aikaterini Varanou
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Mary Falzon
- Department of Pathology, University College London, London, UK
| | | | - Steven E Bottoms
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Bernadette Carroll
- Department of Thoracic Medicine, University College London Hospital, London, UK
| | - Neal Navani
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Department of Thoracic Medicine, University College London Hospital, London, UK
| | - Frank McCaughan
- Department of Biochemistry, University of Cambridge, Cambridge, UK
- Department of Asthma, Allergy and Respiratory Science, King's College London, London, UK
| | - Jeremy P George
- Department of Thoracic Medicine, University College London Hospital, London, UK
| | - Adam Giangreco
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Nicholas A Wright
- Histopathology Laboratory, Cancer Research UK London Research Institute, London, UK
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stuart A C McDonald
- Histopathology Laboratory, Cancer Research UK London Research Institute, London, UK
- Centre for Digestive Diseases, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Trevor A Graham
- Histopathology Laboratory, Cancer Research UK London Research Institute, London, UK
- Centre for Evolution and Cancer, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
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Abstract
Extramedullary plasmacytomas are plasma cell tumors that occur outside the bone marrow. They constitute around 4 % of all plasma cell neoplasms. The most common site of extramedullary plasmacytoma is the upper aerodigestive tract-nasal cavity, paranasal sinuses and oronasopharynx. We are presenting a case of extramedullary plasmacytoma of the trachea. Trachea is an extremely rare site of plasmacytoma. When extraosseous plasmacytoma occur in uncommon sites, the distinction from B cell lymphomas showing extensive plasmacytic differentiation can be difficult and diagnostically challenging.
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Affiliation(s)
- Renu Sukumaran
- Division of Pathology, Regional Cancer Centre, Trivandrum, 695011, Kerala State, India,
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49
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José RJ, Virk JS, Sandison A, Sandhu G, George J. Fibrohistiocytoma: a rare tumour of the trachea. QJM 2013; 106:573-4. [PMID: 23536365 DOI: 10.1093/qjmed/hct071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R J José
- Department of Thoracic Medicine, University College London Hospital, 235 Euston road, London, NW1 2BU, UK.
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50
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Imaizumi M, Nomoto Y, Sugino T, Otsuki K, Omori K. Implantation site-dependent differences for tracheal regeneration with induced pluripotent stem cells (iPS cells). Acta Otolaryngol 2013; 133:405-11. [PMID: 23675768 DOI: 10.3109/00016489.2012.742566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONCLUSION The histological findings and quantitative measurements demonstrated that there were differences in teratoma formation according to the site of implantation. Elucidating the mechanisms of the teratoma formation caused by the site of implantation moves the field another step closer to clinical use of induced pluripotent stem (iPS) cells for tracheal regeneration. OBJECTIVES Our previous study demonstrated the potential for iPS cells to be used as a new cell source for tracheal regeneration. However, teratoma formation remains a major problem. Implantation site-dependent differences in teratoma formation have been reported. In this study, the teratoma-forming propensity after implantation into tracheal defects and abdominal subcutaneous tissue was examined histologically and quantitatively. METHODS Mouse iPS cells were cultured in artificial material under various conditions. After cultivation in vitro, artificial materials with cultured iPS cells were then implanted into cervical tissue around tracheal defects and into abdominal subcutaneous tissue in nude rats. Teratoma formation was evaluated histologically and quantitatively with measurement of maximum diameter (MD). RESULTS Teratoma was observed in 10 of 11 rats with cervical tissue around tracheal defects and in 3 of 11 rats with abdominal subcutaneous tissue implants. The average MD was 5.36 mm in the trachea and 0.97 mm in the abdomen.
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Affiliation(s)
- Mitsuyoshi Imaizumi
- Department of Otolaryngology, School of Medicine, Fukushima Medical University, Japan
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