Research progress on multimodality treatment for primary tracheal adenoid cystic carcinoma / 中华放射肿瘤学杂志

Primary tracheal adenoid cystic carcinoma (TACC) is exceedingly rare. Surgical resection is the main treatment for TACC. Whether the operation is radical or not is a key prognostic factor. Postoperative radiotherapy may be suitable to improve the local control rate and long-term survival for patients with positive surgical margin. For unresectable, recurrent and metastatic TACC patients, definitive radiotherapy, chemotherapy and molecular targeted therapies have yielded certain clinical efficacy. The aim of this review is to summarize the research progress on multimodality treatment for TACC.

Adenoid cystic carcinoma of the tracheobronchial tree:MSCT features / 中国肿瘤临床

Objective:This study is to improves the understanding of adenoid cystic carcinoma (ACC) of the tracheobronchial tree by observing the multi-slice cornputed tomography (MSCT) features. Methods:The MSCT features of 19 cases with primary tra-cheobronchial ACC confirmed by histopathology were retrospectively analyzed. Results:Among the 19 cases, lesions were located in the trachea in seven cases, in the segmental and above segmental bronchi in 10 cases, in the peripheral lung in two cases. Intra-and ex-traluminal growth were observed in 15 cases (79%), whereas broad-based intraluminal lesions were exhibited in two cases (11%). Among the seven cases of tracheal ACC, the CT scans for five cases showed a notable tendency toward submucosal extension. Two cas-es manifested as a diffuse or circumferential wall thickening of the trachea, and the other three cases presented homogeneous mass fill-ing of the trachea with wall thickening. The 10 cases with bronchial ACC were manifested as intra-and extraluminal growth. Eight cas-es presented homogeneous polypoid growth toward the adjacent lumen, and seven cases presented extraluminal parts that were larger than the intraluminal parts. Among 13 contrast-enhanced examinations, three cases were without enhancement, five cases were slightly enhanced, four cases were moderately enhanced, and one case was highly enhanced. Conclusion:MSCT performances of ACC of the tracheo-bronchial tree possessed certain characteristics, such as broad-based mass, intra- and extraluminal growth, and diffuse wall thickening. CT can diagnose tumor malignancy, but the definitive diagnosis for ACC should depend on pathology.

Primary experience of video-assisted rigid laser bronchoscopy in treatment of tracheobronchial tumors / 中华胸心血管外科杂志

Objective To review the primary experience of video-assisted rigid laser bronchoscopy in the treatment of tracheobronchial tumors. Methods From Sep.2002 to Nov.2004, 13 patients (15 procedures) with tracheobronchial tumors were treated with video-assisted rigid bronchoscope. Benign tumors with small pedicles were removed directly. For benign tumors with wide pedicles or tumors extending beyond the wall of air-way, total enucleating through thoracotomy were employed. In cases with malignant tumors, stenosis or obstructions were relieved by implantation of stents or cautering with electric argoulaser knife. For malignant but resectable primary tumors of trachea and main bronchi, rigid bronchoscopy might serue as a preparation of radical resection. Results Of the 5 patients with benign tumors, 4 received endoscopic total resection and 1 were conversed into thoracotomy. For the 8 malignant cases, 3 received stent implantation, 2 had palliative ablation and 3 got curative resections through thoracotomy. No peri-operative complications or death occurred in this group. Conclusion Total resection of benign tracheobronchial tumors or palliative therapy for tracheobronchial malignant stenosis or preparation of radical resection can be performed safely and efficiently by video-assisted rigid bronchoscopy.

Tratamento cirúrgico do schwannoma traqueal / Surgical treatment of tracheal schwannoma

Schwannoma is a rare benign tumor of the proximal tracheobronchial tree. The aim of the present study is to report a case of tracheal schwannoma causing airway obstruction. A 16-year-old woman complained of cough, wheezing and dyspneia. Bronchoscopy and computerized tomography showed a polypoide intratracheal mass obstructing approximately 80 percent of the lumen. The treatment consisted of tracheal resection and primary anastomosis. Histological analysis revealed a tracheal schwannoma. The postoperative course was uneventful and the patient remains well twelve months after surgery.

Small Cell Carcinoma of the Trachea: 1 case report / 대한흉부외과학회지

A rare small cell carcinoma of the trachea was managed in a 59 year old female patient. The diagnosis was confirmed by histopathological and immunohistochemical studies. Surgical resection and adjuvant chemotherapy were done. The patient died 6 months later due to multiple metastasis.

Clinical Experience of Tracheal Resection after Laser Ablation in a Patient having Tracheal Neurilemoma with Tracheal Stenosis / 대한흉부외과학회지

Tracheal neurilemoma, an extremely rare benign tracheal tumor that there has been only one case reported in 1996 throughout the nation, is a slowly progressing disease that obliterates the upper airway, delays diagnosis for its symptom similarity to asthma, and makes intubation for operation difficult. Bronchoscopic is therefore needed for diagnosis. There are two options for the treatment methods, a bronchoscopic resection or open surgical resection; however if intubation is difficult, then the bronchoscopic resection is used first to keep the airway open for the surgical resection. In this case, the severe tracheal stenosis impeding intubation made the surgical resection of the primary tracheal neurilemoma with extratracheal mass impossible; therefore, bronchoscopic laser resection was applied first to optain the airway passage for endotracheal intubation, followed by a successful open surgical resection.

Leiomyoma of the Trachea / 대한흉부외과학회지

Leiomyoma is extremely rare benign tumor of the trachea. A case of leiomyoma of the trachea is described in a 36-year-old man. The patient had a brief history of asthma-like symptoms. Computed tomography of the chest revealed the ovoid lower trachea mass, which was occupying about 80% of the tracheal lumen. At fiberoptic bronchoscopy highly vascularized round mass was seen on the membranous portion of the lower trachea. The tumor was excised by segmental sleeve resection and end-to-end anastomosis of the trachea was performed. Postoperative course was uneventful and bronchoscopic findings showed clear healing of the anastomotic site.

Primary Neurofibroma of Trachea: A Case Report / 대한흉부외과학회지

Benign tumors of the trachea are rare and are usually misdiagnosed as bronchial asthma because of the similarity of the symptoms and signs. Although the prognosis of neurofibroma which originats from Schwann cells is good, it may recur or undergo malignant change, so segmental resection of the trachea is recommended. Recently, we experienced a case of primary neurofibroma of the trachea treated successfully by segmental resection of the trachea and end-to-end anastomosis. We report it with a brief review of literatures.

Tracheal Myoepithelioma / 대한흉부외과학회지

Myoepithelioma is a benign tumor composed of sheets and islands of various proportion of spindle, plasmacytoid, epitheloid, and clear cells. We are reporting of a 38-year-old woman with an extremely rare neoplasm of the trachea, myoepithelioma. The patient had an right neck mass and diagnosed presumptively as the thyroid tumor with tracheal invasion. Resection and anastomosis of the trachea with partial thyroidectomy was done. The tumor was a well circumscribed mass with solid growth pattern and composed of spindle and epitheloid cells, which were positive for S-100 protein and smooth muscle actin. In electron microscopy, a large amount of microfilaments in the cytoplasm and layers of basement membrane-like materials in the intercellular spaces were observed, which are characteristics of myoepithelioma. Patient has been well for 8 months postoperatively.

Primary Tracheal Tumor C / 대한흉부외과학회지

BACKGROUND: Tumors of the trachea are rare despite their histologic similarity to tumors of the main stem bronchus and lung. MATERIALS AND METHODS: Fourteen patients with tracheal tumor underwent surgical, radiational, or laser photocoagulation therapy from March 1981 to July 1996. Nine patients were malignant and five patients were benign. The most common malignant tumor was adenoid cystic carcinoma. RESULTS: Age ranged from 10 to 65 years with mean age of 45.9 years. Most tumors were located middle and lower one-third of trachea. Surgery was done through collar incision, or collar incision with vertical partial sternal division, or left posterolateral thoracotomy, or sternal division with laryngeal release. Two patients died after operation, because of the disruption of anastomosis and airway obstruction,and laryngeal edema after suprahyoid release. Only one patient died after 8 month of diagnosis. The other patients were doing well during the follow-up period.