Intratracheal Mass Research Articles

Ectopic Intratracheal Thyroid: An Illustrative Case Report and Literature Review

A 19-year-old woman was treated with bronchodilators for new-onset dyspnea with exercise. Her symptoms progressively worsened, culminating 4 months later in acute shortness of breath at rest. Flow-volume loops suggested a fixed obstruction and a computed tomography scan of the neck revealed a large subglottic mass. The patient underwent emergent tracheostomy and laryngoscopy and a near-obstructing intratracheal mass was found. Biopsy showed ectopic thyroid tissue. Magnetic resonance imaging of the neck showed a 1.4-cm tracheal lesion and a normally located thyroid gland. The intratracheal mass was resected endoscopically. Pathology revealed hyperplastic ectopic thyroid tissue. The patient has been maintained on thyroid hormone suppression therapy for 2 years without growth of the residual intratracheal thyroid tissue. She recently underwent a surgical palate expansion. We present this case, along with a literature review of ectopic intratracheal thyroid, its epidemiology, possible etiologies, genetic underpinnings, presentation, and treatment. The co-occurrence of an ectopic thyroid, a functioning orthotopic gland, and a high arched palate is also discussed.

Primary tracheal schwannoma (neurilemoma) in a 9-year-old girl

The authors report a case of primary tracheal schwannoma (neurilemoma) causing symptoms of airway obstruction in a 9-year-old girl. Computerized tomography scan showed a polypoid intratracheal mass obstructing 73% of the lumen. Partial tracheal resection with primary anastomosis was performed. Histologic analysis showed a benign neurogenic tumor of Schwann cell origin.

Upper Airway Obstruction Caused by Intratracheal Ectopic Thyroid Tissue during Pregnancy

Herein is report an extremely rare case of an intratracheal ectopic thyroid gland related with pregnancy. A 34-year-old woman, in gestational week 11, presented with stridor, progressive dyspnea and a choking sensation during her second pregnancy. Computed tomography of the neck and chest revealed a round intratracheal mass obstructing the airway. A bronchoscopic biopsy with LASER cauterization was performed, and the histological finding revealed normal thyroid tissue. The external thyroid of the patient was evaluated, but only found benign nodules in the thyroid gland. She underwent a segmental resection of the trachea, including the mass and the 1st tracheal cartilage. The histological findings revealed the intratracheal mass to be composed of benign thyroid tissue with nodular hyperplasia. After surgery, no pulmonary symptoms were evident. This case suggested the effect of pregnancy on thyroid tissue stimulatied due to a combination of an increasing human chorionic gonadotropin (hCG) level and relative iodine deficiency during pregnancy. This is the first report on the detection of intratracheal ectopic thyroid tissue during pregnancy in Korea (J Kor Soc Endocrinol 20:413~420, 2005)

Primary Intratracheal Lymphosarcoma in Four Cats

Four cats presented with clinical signs suggestive of respiratory disease, including dyspnea, wheezing, cyanosis, inspiratory stridor, coughing, and gagging. Radiographs revealed intratracheal masses. Bronchoscopy allowed for lesion localization and collection of samples for cytopathological and histopathological evaluation, which confirmed a diagnosis of lymphosarcoma. Cats treated with systemic chemotherapy or radiation were able to achieve complete remission and long-term resolution of clinical signs.

Tratamento cirúrgico do schwannoma traqueal

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% 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.

Primary tracheal schwannoma

We report a case of a primary tracheal schwannoma causing symptoms of airway obstruction in a 33-year-old man. Bronchoscopy and computerized tomography demonstrated a polypoid intratracheal mass obstructing 90% of the lumen. Tracheal resection with primary anastomosis was performed. Histologic analysis revealed a benign neurogenic tumor of Schwann cell origin.

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

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 …

Adult Croup

Adult croup is a distinct disease entity that probably represents a heterogeneous clinical syndrome. Three cases of adult laryngotracheitis characterized by upper airway infection and progression to airway obstruction are illustrated. Close observation and prompt decisions regarding airway intervention are critical in effective management, and complete resolution is expected.

Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures

Two cases of difficult ventilation are presented, the first caused by endotracheal tube obstruction with nasal turbinate, and the second caused by tracheobronchial obstruction with blood clots. The clinical presentation in each case was characterized by extreme difficulty in ventilating and severe hypercapnia despite vigorous ventilatory efforts with either a mechanical ventilator or resuscitator bag. A simple manipulation of the endotracheal tube cuff helped to differentiate between increased impedance caused by endotracheal tube obstruction as opposed to increased respiratory system impedance beyond the tip of tube. In the second patient, in whom even a short interruption of ventilation was poorly tolerated, simultaneous rigid bronchoscopy (for removal of intratracheal masses) and ventilation via endotracheal tube were successfully performed.

Histiocytosis X: Unusual-Confusing Features of Eosinophilic Granuloma

We report our experience with seven cases of eosinophilic granuloma in which unusual and/or confusing features were encountered. These features include: histologic confusion with desquamative interstitial pneumonitis, diffuse histiocytic lymphoma, eosinophilic pneumonia; cysts filled with air and/or fluid; radiographic onset in the eighth decade of life; intratracheal mass; and focal parenchymal consolidation.

レーザーブロンコスコープの臨床応用

Two cases of tracheal stenosis were successfully treated with the use of a specially designed laser bronchoscope.Case 1. A 32-year-old male.The patient met with a traffic accident in October, 1978. Tracheotomy was performed for lung complication. The tracheostoma was closed two months after the operation.In April, 1980, he was admitted to our hospital as an emergency patient because of severe dyspnea. Cicatricial stenosis of the trachea was observed at the distance of 3cm from the carina. The inside diameter was only 3mm at the stenosis. No traditional procedures were thought to be useful to obtain a good air way. Therefore, we vaporized the cicatricious tissue with the use of the laser bronchoscope.After the vaporization, the lumen of the stenotic area became 6.5cm in diameter, resulting in a normalrange of respiratory function. He has been free from the symtome for 6 months since the operation.Case 2. An 84-year-old female.The patient was a case of recurrent papillary adenocarcinoma of the thyroid gland. She first developed a mass of the thyroid gland in 1957. She had a hemithyroidectomy in 1969. Since then, she had had local recurrence twice and neck metastasis twice, each being surgically treated. In 1980, a recurrent tumor was developed from the anterior wall of the trachea. It occupied a half of the lumen. The tumor was located 3cm below the vocal folds extending 1.3 cm downward.Because of the advanced age and the very slow proliferation of the tumor vaporization of the intra-tracheal mass was performed under the laser broncho-scope as a palliative treatment. Since the operation, she has been free from recurrence for 6 months.On the bases of the clinical experiences described above, we can conclude that laser vaporization under the specially designed bronchoscope is the choice of treatment for some stenotic lesion of the trachea.

The Anesthetic Management of a Patient with an Obstructing Intratracheal Mass

A patient with a large mass in his lower trachea presents a real challenge to the anesthesiologist. The anticipated management and alternatives must be discussed with the surgeons beforehand. This report describes a procedure that successfully managed such a case involving a neurofibroma without evidence of neurofibromatosis.