Pneumonias, Asthma, Pneumothorax, and Respiratory Arrest Caused by a Tracheal Mass

Abstract

Primary tracheal tumors are exceedingly rare.1-3 Tumors of the larynx and lungs respectively occur 75 and 180 times more frequently than tracheal tumors.3Tracheal tumors of neurogenic origin are even rarer.1,4-7 We are aware of only 29 tracheal tumors of neurogenic origin described in the literature, of which 11 have been neurofibromas.3 Most cases go unrecognized for months or years, because the tracheal lumen is often more than 75% occluded before symptoms occur.8 Patients generally have diagnoses of asthma. The correct diagnosis is frequently made when patients respond poorly to conventional asthma treatment.2 We report a case of a child with pneumothoraces and acute respiratory failure caused by an endotracheal neurofibroma. This previously healthy 10-year-old boy was hospitalized with fever and respiratory distress. A diagnosis of pneumonia was made with radiographs, showing bibasilar infiltrates. He was treated with intravenous antibiotics. Two months later, he had a second episode of pneumonia and again was hospitalized. Chest radiographs again showed bibasilar pneumonia. During this admission, wheezing was noted, and a diagnosis of asthma was made. There were no previous asthma symptoms, and pulmonary function tests were never performed. However, there was a maternal family history of asthma. The patient subsequently had multiple visits …