Qiu Jun, Lin Wei, Zhou Min-Li, Zhou Shui-Hong, Wang Qin-Ying, Bao Yang-Yang
Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University 310003, China ; Now Working at Department of Otolaryngology, The People's Hospital of Zhejiang Province 310014, China.
Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University 310003, China.
Int J Clin Exp Pathol. 2015 Jun 1;8(6):7488-93. eCollection 2015.
Primary small cell carcinoma of trachea is even more uncommon and only a few cases have been reported. Our search revealed only 90 cases in the English-language literatures.
we report a case of cervical tracheal small cell cancer. A 67-year-old male presented with over 2-month history of cough and dyspnea. CT and MRI revealed a 1.0 cm × 2.5 cm intraluminal, irregular soft tissue mass in the upper trachea, approximately 2.5 cm below the glottis. A bronchoscopic examination disclosed a large tumor in the cervical trachea and the lesion occupied more than 60% of the tracheal lumen. Cytological examination suggested some poorly differentiated carcinoma cells. The patient received concurrent chemoradiotherapy and did not perform surgery. One week after CCR, the patient occurred difficulty in breath and tracheal stent was implanted. The symptom was improved markedly. Four days after implant of tracheal stent, the patient presented irritable cough and hemoptysis. The amount of bleeding was about 300 ml. The hemorrhage stopped by treatment of vasoconstrictor and fresh plasma. However, two days later, hemoptysis was continuing even if treatment of vasoconstrictor and fresh plasma. The patient and relatives waived the further therapies. The patient died of massive hemoptysis one week out of hospital.
The tracheal small cell cancer is rare. The optimal treatment is unclear. In general, the strategy is introduced concurrent chemoradiotherapy following as small cell lung cancer. In cervical trachea, we suggest that surgical resection should be performed followed by postoperative adjuvant therapy.
原发性气管小细胞癌更为罕见,仅有少数病例报道。我们的检索发现英文文献中仅有90例。
我们报告一例颈段气管小细胞癌病例。一名67岁男性,有2个多月的咳嗽和呼吸困难病史。CT和MRI显示气管上段距声门约2.5 cm处有一个1.0 cm×2.5 cm腔内不规则软组织肿块。支气管镜检查发现颈段气管有一个大肿瘤,病变占据气管腔超过60%。细胞学检查提示有一些低分化癌细胞。患者接受同步放化疗,未进行手术。完全缓解(CCR)一周后,患者出现呼吸困难,植入气管支架。症状明显改善。气管支架植入4天后,患者出现刺激性咳嗽和咯血。出血量约300 ml。经血管收缩剂和新鲜血浆治疗后出血停止。然而,两天后,即使使用血管收缩剂和新鲜血浆治疗,咯血仍在继续。患者及其家属放弃进一步治疗。患者出院一周后死于大量咯血。
气管小细胞癌罕见。最佳治疗方法尚不清楚。一般来说,治疗策略是按照小细胞肺癌进行同步放化疗。对于颈段气管,我们建议应先进行手术切除,然后进行术后辅助治疗。