Djaković Željko, Janevski Zoran, Cesarec Vedran, Slobodnjak Zoran, Stančić-Rokotov Dinko
Jordanovac Department of Thoracic Surgery, Zagreb University Hospital Centre, Zagreb, Croatia.
Acta Clin Croat. 2019 Dec;58(4):777-779. doi: 10.20471/acc.2019.58.04.27.
Primary malignant tumors of the trachea are very rare with the incidence of less than two million people year, and only ten percent of them are adenoid cystic carcinomas. Eighty percent of all tracheal tumors are malignant. Diagnosis is usually late because the symptoms mimic other conditions such as asthma. Clinical picture may sometimes be dramatic when airway is almost closed and emergency recanalization is necessary. Diagnosis is made by chest computed tomography scan or magnetic resonance imaging. Definitive treatment is surgical resection alone or followed by radiation therapy or radiation therapy alone. Radical resection is only accomplished in about half of all cases because of the submucosal tumor growth and limited length of tracheal resection. The role of adjuvant radiation therapy in negative resection margin cases is not clear but all patients with positive resection margin benefit from radiation therapy. We present a case of a 43-year-old patient with primary adenoid cystic carcinoma of distal trachea treated by emergency bronchoscopic recanalization and resection of the tracheal tumor with end-to-end anastomosis.
气管原发性恶性肿瘤非常罕见，发病率低于每年200万人，其中只有10%是腺样囊性癌。所有气管肿瘤中80%为恶性。由于症状与哮喘等其他疾病相似，诊断通常较晚。当气道几乎闭合且需要紧急再通时，临床表现有时可能很严重。通过胸部计算机断层扫描或磁共振成像进行诊断。确定性治疗是单独手术切除或术后放疗，或仅行放疗。由于肿瘤在黏膜下生长且气管切除长度有限，只有约一半的病例能完成根治性切除。辅助放疗在切缘阴性病例中的作用尚不清楚，但所有切缘阳性的患者都能从放疗中获益。我们报告一例43岁患者，患有气管远端原发性腺样囊性癌，接受了紧急支气管镜再通及气管肿瘤切除并端端吻合术。
