Tracheal Tumors Research Articles

Upper respiratory tract tumors in Cpb:WU (Wistar random) rats.

A survey is given of upper respiratory tract tumors in Cpb:WU (Wistar random) rats. Data were collected from ten 24- to 30-month toxicity/carcinogenicity studies and from one 12-month study. Nasal tumors may lead to dyspnea, mouth breathing, and nasal discharge. These clinical signs mainly occurred in rats bearing squamous cell carcinomas. The large nasal tumors were often osteolytic, they invaded the subcutis over the premaxilla, resulting in swellings on the back of the nose, and extended into the brain. The incidence of nasal tumors in untreated male controls was 1.1% (7/661), the tumors invariably being squamous cell carcinomas. There were no nasal tumors found in untreated female controls. The type of compound-induced nasal tumor most frequently observed was adenocarcinoma (of the olfactory epithelium) followed, in order of decreasing incidence, by squamous cell carcinoma, carcinoma in situ, polypoid adenoma, Schwannoma, and carcinosarcoma. It was proposed that adenocarcinomas of the olfactory epithelium should be classified as neuroepitheliomas. It was also suggested that squamous cell carcinomas, seen in association with necrotizing inflammation of an incisor tooth, should be considered as part of the malocclusion syndrome. No spontaneous tracheal tumors were observed, and only one out of 422 untreated female controls (0.2%) was seen to have a laryngeal tumor, an adenoma. Induced laryngeal tumors included carcinoma in situ, squamous cell carcinoma, and adenocarcinoma. Squamous cell carcinoma was the only type of treatment-related tracheal tumor found. The incidences of induced laryngeal and tracheal tumors were very low, and in no case were these tumors statistically significantly different from the respective incidences in controls.

Histological types of laryngotracheal tumors induced in Syrian golden hamsters by nitrosomorpholine and nitrosopiperidine

The chronic oral administration of nitrosomorpholine (NM) and nitrosopiperidine (NP) to 360 adult Syrian golden hamsters of both sexes resulted in the induction of a high incidence of laryngo-tracheal tumors, which in the group treated with 0.01% solution of NM affected up to 80% of the males. A total of 232 different laryngo-tracheal tumors were found. 36 of these were located within the supraglottic and glottic larynx, 62 were within the subglottic and glottic larynx, and 134 arose within the trachea. Among the laryngeal supraglottic and glottic tumors there were 18 squamous cell carcinomas, 16 squamous cell papillomas and only 2 mixed cell mucoepidermoid papillomas. All the subglottic laryngeal tumors and tracheal tumors were mixed cell mucoepidermoid papillomas. In this study, the squamous cell carcinomas observed within the larynx of hamsters bear morphological and biological similarities to their tumor counterpart found in the larynx of adult man. The laryngeal squamous papillomas observed in this experiment are not similar to the squamous papillomas occurring in man during infancy and childhood. The mixed cell mucoepidermoid papillomas of the hamster trachea and subglottis are a peculiar neoplasm of this species, which morphologically and biologically differs from the cases of tracheal papillomatosis described in man, as well as from the mucoepidermoid tumors of major and minor salivary gland origin also seen in this latter species.

気管神経鞘腫と前縦隔胸腺嚢腫の併存した１例と気管神経鞘腫の文献的考察

A mass radiographic examination of the chest disclosed an asymptomatic abnormal mediastinal shadow protruding to the right thoracic cavity in a 41-year-old house wife. At the time of evaluation of the tumor shadow, a radiopaque shadow in the trachea was incidentally discovered. Bronchoscopic examination revealed a smooth-surfaced, yellowish white, round tumor originating from the anterior wall at the level of lower third of the trachea and occluding two thirds of the lumen. But a definite diagnosis was not established. Transthoracic needle aspiration biopsy of the mediastinal tumor was of no diagnostic value. Although she was quite asymptomatic at the time, surgical treatment was thought to be reasonable because the trachea was threatened eventually to be occluded completely by the tumor. Removal of the anterior mediastinal tumor was followed by tracheal sleeve resection with end-to-end anastomosis. The mediastinal tumor was a thymic cyst and the tracheal tumor was a neurilemmona.Tracheal neurilemmomas are rare and only 19 documented cases in the world literature were found.

腫ようによる気管狭窄

Since 1980, we began applying fiberoptic bronchoscopic Nd-YAG laser treatment fortracheal-carinal tumors. Endoscopic Nd-YAG laser treatment and adjuvant therapy wereperformed in 16 cases of primary tracheal tumor (12 malignant lesions and 4 benign lesions) and 39 cases of metastatic tracheal lesions. For 28 cases presenting severe respiratory distress, the procedure was performed as an emergency life-saving procedure and dramatic improve-ment in condition was seen in 26 cases (92. 9%) . Twenty seven cases were treated by stagedlaser reduction of the residual airway lesion. Effectiveness was observed in 24 cases (88. 9%) . In these cases, after Nd-YAG laser treatment for ventilatory improvement, local or systemicadjuvant therapy was performed. Local adjuvant therapy was performed in 29 cases, 11 caseswere treated surgically (4 tracheoplasties and 10 treacheal tube stent operations) and 28 casesunderwent radiotherapy.In addition to these cases, there were 5 cases who underwent tracheal resection withoutpreoperative Nd-YAG laser treatment. These 5 cases consisted of 3 tracheal tumors and 3metastatic lesions from the thyroid gland.Bronchoscopic Nd-YAG laser treatment is a relatively new method for the treatment oftracheal or carinal tumor with ventilatory disturbance due to airway stenosis.

Limited and radical resection for tracheal and bronchopulmonary carcinoid tumour *1Report on 227 cases

Bronchopulmonary carcinoid tumours occur at all levels from the trachea to the lung periphery. Over a 20-year period. 227 patients with carcinoid tumour underwent thoracotomy. The age at operation ranged from 14 to 79 years. Haemoptysis, chronic cough, recurrent infection and wheeze were the most common symptoms; 24% of patients were asymptomatic. The primary tumour was within the trachea or the main, lobar or segmental bronchi in 190 patients (83.7%). A variety of surgical procedures were employed: pneumonectomy in 32 patients; lobectomy and bilobectomy including bronchial sleeve resection in 144; segmentectomy in 18; wedge excision in 19; bronchial sleeve only in 5; carinal resection in 2; tracheal resection in 4 and bronchotomy in 3 cases. There was only 1 hospital death in the 227 patients (mortality: 0.44%). Survival at 5 and 10 years in patients with benign carcinoid was 97.5% and 95%, respectively. In patients with the atypical form it was 41.2%. The peripheral carcinoid was usually totally removed by an ample wedge excision or segmental resection and the central bronchial carcinoid by sleeve resection with lobectomy rather than pneumonectomy. The atypical variant, because of the frequency of lymphatic involvement, should be treated as a bronchial carcinoma by radical resection.

Primary tracheal tumors: Treatment and results

One hundred ninety-eight patients with primary tracheal tumors were evaluated in 26 years. One hundred forty-seven tumors were excised (74%): 132 (66%) by resection and primary reconstruction, seven by laryngotracheal resection or cervicomediastinal exenteration, and eight by staged procedures. Eleven more were explored. Forty-four squamous cell carcinomas were resected, 60 adenoid cystic, and 43 assorted tumors, benign and malignant. Eighty-two patients underwent tracheal resection with primary reconstruction, and 50 had carinal resection and reconstruction. Surgical mortality for resection with primary reconstruction was 5%, with one death after tracheal and six after carinal repair. Six patients had stenosis after tracheal or carinal resection; all underwent reresection successfully. Nearly all patients with squamous or adenoid cystic carcinoma were irradiated postoperatively. Twenty of 41 survivors of resection of squamous cell carcinoma are living free of disease (some for more than 25 year), 39 of 52 with adenoid cystic carcinoma (up to nearly 19 years), and 35 of 42 with other lesions (5 lost to follow-up). Comparison of length of survival of patients with squamous cell carcinoma and adenoid cystic carcinoma who are alive without disease with those who died with carcinoma supports surgical treatment (usually followed by irradiation). Positive lymph nodes or invasive disease at resection margins appear to have an adverse effect on cure of squamous cell carcinoma; such an effect is not demonstrable with adenoid cystic carcinoma.

SCANNING ELECTRON MICROSCOPIC OBSERVATIONS ON PRENEOPLASTIC AND NEOPLASTIC LESIONS OF THE TRACHEA IN SYRIAN GOLDEN HAMSTERS INDUCED BY DIETHYLNITROSAMINE

Ultrastructural observations by scanning electron microscope (SEM) of pre- or neoplastic tracheal lesions in Syrian golden hamsters induced by diethylnitrosamine (DEN) were investigated. Twenty five, six-week-old, male Syrian golden hamsters were injected subcutaneously twice a week for 12 weeks with 18mg/kg body weight of DEN. Six hamsters were injected only vehicle and served as control. At weeks 2, 4, 8, 12, and 16, 5 hamsters of DEN treated group were sacrificed. At weeks 2, 8, and 12, hamsters of vehicle control group were also sacrificed. Sequential changes of tracheal tumors were investigated by ultrastructural and histopathological observations. At week 2, a focal loss of cilia from surface cells of the trachea of DEN treated hamster were already detected by SEM. At week 4, decilinated changes of the surface became more markedly, and at week 8, various kinds of preneoplastic and neoplastic changes were observed in trachea of DEN treated hamster. Those changes could be detected by microscopy as well as SEM. By week 16, papillary tumors were found in all animals treated with DEN. No changes were observed in trachea of control animals. These results showed that scanning observations can detect the very early lesions of trachea and it is a very useful method especially for detecting the changes of tracheal lesions on hamster tracheal carcinogenesis.

Tracheal Carcinoid : a case report

A 77 year-old woman was admitted because of dyspnea. Chest radiograms and bronchofiberscopic examination revealed a tracheal tumor located 1.5 cm above the tracheal carina. Biospy was not carried out to avoid bleeding from the tumor. Circumferential tracheal resection was done for a length of four cartilage rings and end-to-end anastomosis was performed. Microscopic examination revealed primary tracheal carcinoid. Although microscopic lesions remained at the distal part of the anastomosis, an additional resection was not performed due to instability of cardiopulmonary function. After radiation therapy she has been well during the three years since the operation.

Noncardiogenic Pulmonary Edema Following Laser Therapy of a Tracheal Neoplasm

Nd-YAG laser phototherapy has been demonstrated to be effective for the treatment of airways obstruction caused by tracheal tumors. Pulmonary edema has been reported as a complication following acute relief of an upper airway obstruction. We describe a case where laser photoresection of an endotracheal malignancy resulted in acute pulmonary edema. It is important to recognize this potential cause of respiratory deterioration following successful phototherapy to obstructing lesions of the upper airways.

Glomus tumor of the trachea. Report of a case with ultrastructural observation

Extracutaneous glomus tumors are unusual and their occurrence in the trachea has been recognized with extreme rarity. We present a case of surgically resected glomus tumor of the trachea in a 54-year-old woman who was initially misdiagnosed as having bronchial asthma because of expiratory wheezing. The tumor, located 7 cm below the vocal cord and 5 cm above the carina, was an intraluminally protruding polypoid mass that measured 1.5 X 1.2 cm and arose from the posterior wall of the trachea with a broad base. Microscopically, the tumor was predominantly of the solid type, but a small proportion of a glomangiomatous component was admixed. Ultrastructural study confirmed the presence of myofibrillar bundles with focal densities and fine pinocytotic vesicles along the plasma membrane. A structure similar to a nonneoplastic glomus was demonstrated in the submucosal layer of the posterior wall away from the tumor margin. This suggests that the tracheal glomus tumor occurs more often in the posterior wall where neuromuscular complex structures may develop more readily.

Primary tumors of the trachea. Results of radiation therapy.

From 1959 to 1986, 24 patients with primary malignant tumors of the trachea received radiotherapy as all or part of treatment. Common presentations included respiratory symptoms in 20 patients and hemoptysis in 15. Thirteen patients had squamous carcinomas with undifferentiated and adenoid cystic cancers in five and four patients, respectively. Overall actuarial survival was 45% at 1 year, 25% at 5 years, and 13% at 10 years. Survival was significantly correlated to histologic type (adenoid cystic versus squamous, P less than 0.03), but not to tumor extent or to patient age or sex. Local control was attained in 10 of 24 patients overall and was more frequent for patients with tumors localized to the trachea and for patients who were treated with combined surgery and radiotherapy. For the 18 patients treated with radiotherapy alone, complete response (CR) was seen to be significantly (P less than 0.001) related to dose: six of seven (86%) patients receiving greater than or equal to 6000 cGy attained CR versus one of 11 (9%) receiving less than 6000 cGy. Three patients developed complications related to radiotherapy. Radiotherapy can provide durable local control of localized tracheal tumors and should be considered for medically inoperable patients with localized tumors and for patients with high risk of recurrence after resection.

Radiotherapy for primary carcinoma of the trachea

Between 1940 and 1985, 24 cases of primary carcinoma of the trachea were registered at the London Regional Cancer Centre. The most common presenting symptoms were hoarseness, haemoptysis and cough. Twenty patients had epidermoid carcinoma and four had adenoid cystic carcinoma. Because of different clinical behaviours, the two histologies were separately analyzed. Of the 20 patients with epidermoid carcinoma, 19 received radiotherapy as primary treatment and one patient did not receive radiotherapy because of advanced disease. Radiation doses ranged from 4000 to 6000 cGy and most patients had megavoltage irradiation. Treatment result was disappointing. Only one patient remained disease-free at 15-month follow-up and all other patients had persistent or recurrent tracheal tumour. Median survival for all 20 patients was 5 months (range 1 to 19 months). Of the four patients with adenoid cystic carcinoma, two had primary surgery and postoperative radiotherapy and two had primary radiotherapy. Two patients died of disease, at 5 months and 8 years from diagnosis. Two surviving patients had 15-month follow-up: one had persistent disease and the other was free from recurrence. In this study, radiotherapy within the range of doses given was found to be an ineffective primary treatment for tracheal carcinoma.

Anesthesia for Laser Resection of a Tracheal Tumor in a Woman Pregnant With Twins

Anesthesia for Laser Resection of a Tracheal Tumor in a Woman Pregnant With Twins

High Frequency Jet Ventilation in Tracheal Tumor Surgery

High Frequency Jet Ventilation in Tracheal Tumor Surgery

Glomus Tumor of the Trachea: Immunohistochemical and Electron Microscopic Studies

Glomus tumor of the trachea which developed in a 51-year-old man was reported. He experienced frequent episodes of respiratory infections and hemoptosis for 9 months. Bronchofiberscopic study demonstrated a polypoid tumor in the upper trachea. Local resection of the tumor was performed and it arised from the membranous portion of the third and fourth tracheal rings. Histologically, the tumor was composed of medium-sized rounded cells, resembling carcinoid tumor. Desmin and myosin immunoreactivities were found in most of the tumor cells. Electron microscopic examination showed that the tumor cells contained fine filaments with focal density, numerous pinocytotic vesicles along the plasma membrane and abundant mitochondria. The patient is well without evidences of tumor recurrence 2 years after the resection. This is the fourth report of the tracheal glomus tumor with definitive evidences of smooth muscle differentiation of the tumor cells.

Successful cryotherapy of a benign tracheal neoplasm

A 10-year-old black male with a 6-month history of progressive dyspnea and stridor was found to have a submucosal mass occupying 75% of the subglottic airway. Biopsy specimens showed a pleomorphic adenoma of minor salivary gland origin--a tumor with a predilection for local recurrence after resection. A tracheostomy was performed for airway control and the lesion was treated with endotracheal cryotherapy. Two months later, the tracheostomy was removed and the patient has remained asymptomatic for 9 years. Pulmonary function studies 2 years following cryotherapy demonstrated a forced vital capacity (FVC) of 81% predicted, and a forced expiratory volume-one second (FEV-1) of 73% predicted. Bronchoscopy with biopsy at 5 years showed no evidence of recurrent airway obstruction or persistent tumor. This represents the first reported case of successful treatment of an airway tumor in a child utilizing profound cryotherapy. The case illustrates the utility of endotracheal cryotherapy in the treatment of certain benign and malignant obstructing lesions of the airway in children.

Endobronchial Electrosurgery

Endobronchial electrosurgery (EBES) with the aid of a fiberoptic bronchoscope and a diathermic snare has been performed in 14 patients with tracheal and bronchial tumors (eight with benign, one with carcinoid, and five with malignant tumors). Total eradication has been achieved in the nine patients with benign and carcinoid tumors. In some patients, EBES was supplemented with surgical removal with the biopsy forceps or laser coagulation. Electroexcision of the endobronchial portion of the tumor helped to clear the respiratory airways in three of the five patients with malignant tumors. Emergent EBES was performed in two patients with acute respiratory failure and massive hemorrhage caused by adenocystic and thyroid cancer of the trachea.

Intracavitary Hyperthermia: A Newly Designed Applicator for Tracheal Tumors: Endocurietherapy/Hyperthermia Oncology, Vol. 3, No. 1, January 1987, pp. 23–29

Intracavitary Hyperthermia: A Newly Designed Applicator for Tracheal Tumors: Endocurietherapy/Hyperthermia Oncology, Vol. 3, No. 1, January 1987, pp. 23–29

切除不能気管腫ように対する治療 特にＡｄｅｎｏｉｄ ｃｙｓｔｉｃ ｃａｒｃｉｎｏｍａについて

切除不能気管腫ように対する治療 特にＡｄｅｎｏｉｄ ｃｙｓｔｉｃ ｃａｒｃｉｎｏｍａについて

Laryngeal involvement by thyroid disease.

Thyroid tissue or neoplastic derivatives therefrom in the larynx or trachea have their genesis in either ectopia or a direct invasion by carcinoma of the thyroid gland proper. The benign lesions are found preponderantly in patients from regions in which goiter is endemic, and they may represent as much as 7% of all benign tracheal tumors. Laryngotracheal invasion by thyroid carcinoma also has a frequency of approximately 7%, with all histologic types represented.