ENT, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
ENT, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.
BMJ Case Rep. 2022 Nov 4;15(11):e252310. doi: 10.1136/bcr-2022-252310.
Spindle cell carcinoma is a subtype of sarcomatoid carcinoma, which has previously been described in various anatomical locations, though rarely in the trachea.We present the case of a woman in her 70s who presented with a sore throat and stridor. Fibreoptic nasendoscopy demonstrated a tracheal mass occupying 80% of the airway from the cricoid cartilage to the third tracheal ring, infiltrating the thyroid gland. Subsequent CT demonstrated pulmonary emboli and vertebral metastasis. Biopsy of the infiltrated thyroid confirmed the diagnosis of spindle cell carcinoma. The length of the tumour and metastasis at presentation made this surgically unresectable, and she was referred for a palliative stent but died after an acute deterioration.This pathology has been reported only five times previously in the literature, with management strategies varying greatly between patients. Primary tracheal tumours are difficult to manage as, due to their rarity, there are no clear guidelines.
梭形细胞癌是肉瘤样癌的一种亚型，以前曾在不同的解剖部位描述过，尽管在气管中很少见。我们报告了一位 70 多岁女性的病例，她因咽痛和喘鸣而就诊。纤维鼻咽喉镜检查显示气管内肿块从环状软骨到第三气管环占据了气道的 80%，浸润了甲状腺。随后的 CT 显示肺栓塞和椎体转移。浸润甲状腺的活检证实了梭形细胞癌的诊断。肿瘤的长度和转移在呈现时使手术无法切除，她被转介进行姑息性支架治疗，但在急性恶化后死亡。这种病理学以前在文献中仅报道过 5 次，患者之间的治疗策略差异很大。由于原发性气管肿瘤非常罕见，因此没有明确的治疗指南，因此很难进行管理。
