Primary malignant airway neoplasms in 4 children

Abstract

Primary airway neoplasms are extremely rare in the pediatric age group. This paper reports 4 children with primary airway neoplasms to explore the clinical manifestations, safety and efficacy of bronchoscopic interventions. The data of pathology, photographic documentation and imaging studies were analyzed. Of the 4 reported lesions, 2 were characterized by low-grade (2 with mucoepidermoid carcinoma) and 2 by high grade malignant (spindle cell carcinoma and malignant lymphoma). Onset of clinical manifestations occurred at the ages of 7 months to 7 years. All of them were initially misdiagnosed as bronchitis, asthma or atelectasis. The lesions located in trachea in 2 patients, in left bronchus of 1 patient and in right middle bronchus of 1 case. Atelectases occurred in bilateral bronchus where the lesions obstructed almost the entire lumen at the time of diagnosis. The diagnosis of airway masses depends upon maintaining a high index of suspicion, complemented by imaging and timely diagnostic endoscopy. The lesions were completely removed in 3/4 patients except 1 died during bronchoscopic procedures. The children with malignant airway neoplasms were presented with cough and wheezing without specific manifestations. Bronchoscopic interventions were effective in the treatment of non-operative cases. General anesthesia is strongly recommended for interventional bronchoscopy.