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Thoracic Cancer Apr 2024Primary 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... (Review)
Review
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.
Topics: Humans; Male; Female; Tracheal Neoplasms; Retrospective Studies; Trachea; Prognosis; Disease-Free Survival; Carcinoma, Squamous Cell; Carcinoma, Adenoid Cystic
PubMed: 38429910
DOI: 10.1111/1759-7714.15231 -
Einstein (Sao Paulo, Brazil) 2024Schwannomas commonly develop in the cervical region, 25% - 45% of cases are diagnosed in this anatomical region. Tracheal neurogenic tumors are exceedingly rare and can...
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.
Topics: Humans; Thyroid Cancer, Papillary; Trachea; Thyroid Neoplasms; Tracheal Neoplasms; Neurilemmoma
PubMed: 38324847
DOI: 10.31744/einstein_journal/2024RC0528 -
Thorax Aug 1993The trachea is an unusual site for paragangliomas, only four cases having been documented previously. A fifth case is presented here, together with immunohistochemical...
The trachea is an unusual site for paragangliomas, only four cases having been documented previously. A fifth case is presented here, together with immunohistochemical evidence that the tumour is biologically benign.
Topics: Female; Glial Fibrillary Acidic Protein; Humans; Middle Aged; Neoplasm Proteins; Paraganglioma; Tracheal Neoplasms
PubMed: 8211879
DOI: 10.1136/thx.48.8.866 -
Thorax Nov 1989A 50 year old man was found to have a tracheal lipoma two years after first noticing symptoms.
A 50 year old man was found to have a tracheal lipoma two years after first noticing symptoms.
Topics: Asthma; Bronchitis; Diagnosis, Differential; Humans; Lipoma; Male; Middle Aged; Tracheal Neoplasms
PubMed: 2595641
DOI: 10.1136/thx.44.11.980 -
Thorax May 1991The prognosis for tracheobronchial tumours remains poor. Most patients can be offered only palliation. When the main symptom is breathlessness or refractory haemoptysis... (Review)
Review
The prognosis for tracheobronchial tumours remains poor. Most patients can be offered only palliation. When the main symptom is breathlessness or refractory haemoptysis from a large airway tumour endoscopic treatment may be very effective. Over the last decade most attention has focused on the neodymium YAG laser. This often produces dramatic effects but has some important limitations. In the last few years better techniques for stenting and intrabronchial radiotherapy (brachytherapy) have also been developed. This article discusses the range of techniques now available and aims to help clinicians decide which patients may benefit from referral to centres providing these techniques.
Topics: Brachytherapy; Bronchial Neoplasms; Cryosurgery; Diathermy; Endoscopy; Humans; Laser Therapy; Palliative Care; Stents; Tracheal Neoplasms
PubMed: 1712516
DOI: 10.1136/thx.46.5.325 -
Journal of Postgraduate Medicine 2018Primary tracheal tumors are rare and trachea is an exceedingly rare site of extramedullary plasmacytoma (EMP). We report a case of solitary tracheal plasmacytoma causing...
Primary tracheal tumors are rare and trachea is an exceedingly rare site of extramedullary plasmacytoma (EMP). We report a case of solitary tracheal plasmacytoma causing symptoms of airway obstruction in a 59-year-old man. Flow/volume loop indicated the fixed central airway obstruction. Computerized tomography and bronchoscopy demonstrated a sessile tumor on posterior tracheal wall obstructing 80% of the lumen. Partial tracheal resection with T-T anastomosis was performed. Pathologic analysis of resected mass revealed EMP. Additional investigations excluded multiple myeloma. There are no signs of disease recurrence after 7-year follow-up.
Topics: Airway Obstruction; Anastomosis, Surgical; Bronchoscopy; Humans; Male; Middle Aged; Multidetector Computed Tomography; Plasmacytoma; Trachea; Tracheal Neoplasms; Treatment Outcome
PubMed: 29067926
DOI: 10.4103/jpgm.JPGM_739_16 -
Technology in Cancer Research &... 2021There is limited understanding of tracheal carcinoma (TC) because of its rarity. We examined the efficacy of radiotherapy (RT) for patients with primary TC. (Clinical Trial)
Clinical Trial
BACKGROUND
There is limited understanding of tracheal carcinoma (TC) because of its rarity. We examined the efficacy of radiotherapy (RT) for patients with primary TC.
METHODS
We analyzed the records of 32 patients with primary TC who received RT at our center between November 1996 and December 2016.
RESULTS
Thirteen patients received adjuvant RT and 18 received definitive RT. Eight patients achieved complete remission (CR) after definitive RT. Among all patients, the 5-year overall survival (OS) rate was 46.9% and the locoregional progression free survival (LRPFS) rate was 68.1%. Univariate analysis indicated the 5-year OS was better in those with adenoid cystic adenocarcinoma than squamous cell carcinoma ( = 0.001); the 5-year LRPFS was better in patients who received surgical resection than those who did not (92.9% vs 46.4%, = 0.013) and in patients who received postoperative RT than in those who received definitive RT (91.7% vs 50.1%, = 0.038). A sub-group univariate analysis indicated the 5-year PFS was better for those who received at least 68 Gy of radiation (44.4% vs 13.0%, = 0.044). Patients who achieved CR had a better 5-year PFS than those who did not (57.1% vs 10%, = 0.006). No patients had a toxicity of grade 3 or more.
CONCLUSIONS
Adjuvant and definitive RT are safe and effective treatments for TC. Patients who received dosages of 68 Gy or more and who had complete tumor regression following definitive RT seemed to have better long-term survival.
Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prognosis; Radiotherapy, Adjuvant; Radiotherapy, Intensity-Modulated; Retrospective Studies; Survival Rate; Tracheal Neoplasms
PubMed: 34372715
DOI: 10.1177/15330338211034273 -
Experimental Biology and Medicine... Jan 2017The objective was to assess the safety and outcome of cold snare technique used by flexible bronchoscopy in the treatment of airway benign neoplasms. The clinical data...
The objective was to assess the safety and outcome of cold snare technique used by flexible bronchoscopy in the treatment of airway benign neoplasms. The clinical data of 21 patients, who had airway benign neoplasm and were treated through the cold snare method in Sir Run Run Shaw Hospital, affiliated with the Zhejiang University, were retrospectively analyzed. The relief of the symptoms and occurrence of complications were observed and evaluated. All the tumors were benign and removed by cold snare. Postoperatively, we found that the treatment was completely effective in 12 patients, and there was a significant improvement in 7 patients and a moderate improvement in 2 patients, and no recurrence in follow-up visit. In conclusion, the cold snare technique is an economically feasible, safe, and effective method in the treatment of airway neoplasms.
Topics: Adult; Aged; Bronchoscopy; Female; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Retrospective Studies; Trachea; Tracheal Neoplasms; Treatment Outcome; Vocal Cords
PubMed: 27590501
DOI: 10.1177/1535370216668053 -
The American Journal of Case Reports Dec 2019BACKGROUND Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare disease entity. It arises from ectopic thymic tissue in the thyroid gland. Patients... (Review)
Review
BACKGROUND Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare disease entity. It arises from ectopic thymic tissue in the thyroid gland. Patients usually present with enlarging neck mass and hoarseness. CASE REPORT A 49-year-old man presented to our clinic with hoarseness and a right thyroid mass. Ultrasound showed a 6-cm right thyroid tumor and computer tomography confirmed invasion into the trachea. He received total thyroidectomy together with excision of one-third of the tracheal wall. No gross tumor was left behind. The tracheal defect was repaired using a pedicled right sternocleidomastoid muscle flap. He had a good recovery and was discharged 2 days after surgery. Histology revealed carcinoma showing thymus-like differentiation (CASTLE). The patient had regular follow-up and showed no clinical evidence of recurrence 18 months after surgery. CONCLUSIONS Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare yet potentially extensive disease with favorable prognosis. Imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), is helpful in aiding diagnosis and operative planning. Surgical resection is currently the treatment of choice, with generally favorable outcomes. The role of adjuvant therapies such as radiotherapy and chemotherapy require further studies.
Topics: Hoarseness; Humans; Male; Middle Aged; Neoplasm Invasiveness; Thyroid Neoplasms; Thyroidectomy; Tomography, X-Ray Computed; Tracheal Neoplasms; Tracheotomy; Ultrasonography
PubMed: 31819030
DOI: 10.12659/AJCR.919208 -
Chinese Clinical Oncology Dec 2015Surgical research has failed during fifty years to find an ideal substitute for the trachea after extended resection. All the prostheses could erode the adjacent...
Surgical research has failed during fifty years to find an ideal substitute for the trachea after extended resection. All the prostheses could erode the adjacent structures or lead to infection or obstructive issues. Innovation in surgery development has been improved using novel techniques of plastic surgery. During the last ten years, we have developed a technique using free fasciocutaneous flaps. This allows us to construct tubes for tracheal replacement. The most accurate flap used for this technique is the forearm free flap (FFF). Reinforcement of the flap with autologous strips of cartilage harvested from the last ribs offers sufficient resistance to respiratory pressure. This technique is also completely autologous without any stent in the tracheal lumen. From 2004 to 2015 we have already reconstructed the trachea of 16 patients for 12 primary tracheal neoplasms [including 9 adenoid cystic carcinoma (ACC) and 3 squamous cell carcinoma (SCC)], 3 secondary tracheal Neoplasms and one for benign lesion. This article describes the indications, determination of resectability, patient selection, subheading for surgery, postoperative management and results of this technique.
Topics: Adult; Aged; Cartilage, Articular; Female; Free Tissue Flaps; Humans; Male; Middle Aged; Patient Selection; Plastic Surgery Procedures; Ribs; Risk Factors; Trachea; Tracheal Neoplasms; Transplantation, Autologous; Treatment Outcome; Young Adult
PubMed: 26730758
DOI: 10.3978/j.issn.2304-3865.2015.12.07