Messina Gaetana, Bove Mary, Natale Giovanni, Fiorelli Alfonso, Vicidomini Giovanni, Santini Mario, Ronchi Andrea, Pirozzi Mario, Facchini Sergio, Ciardiello Fortunato, Fasano Morena
Thoracic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Transl Cancer Res. 2023 Mar 31;12(3):646-650. doi: 10.21037/tcr-22-1622. Epub 2023 Mar 15.
Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm, generally arising in the visceral pleura. It rarely originates from other sites such as trachea, orbital cavities, nasal cavities, peritoneum, paranasal sinuses, meninges, salivary glands, thyroid gland, diaphragm, liver, pancreas, lung kidney, adrenal gland, mediastinum, spermatid cord, pericardium, urinary bladder, prostate, uterine cervix, testis, spinal cord, periosteum, skin, soft tissue and bone.
We present a surgical case of a rare primary tracheal tumor. High resolution computed tomography (HRCT) scan of the chest showed a 5 mm hypodense lesion, located on the right lateral wall of the proximal third of trachea; however the tracheal lumen was normal. We performed a rigid bronchoscopy in order to remove the endotracheal tumor with palliative purposes only. For this reason, we did not perform a prior histologic examination. The lesion was easily removed with common biopsy forceps and with standard aspirator. The debulking of the tumor was achieved with the use of laser Nd-YAP, electrocautery was used also for hemostasis to prevent bleeding during the operation. Without complications during the endoscopic treatment, the procedure was well tolerated by the patient. The pathological diagnosis was SFT.
SFT located in the trachea can be endoscopically resceted. Endoscolical treatment is indicated for patients with poor clinical conditions (heart disease, respiratory failure) that are not elegible for surgical resection.
孤立性纤维瘤（SFT）是一种罕见的间叶性肿瘤，通常起源于脏层胸膜。它很少起源于其他部位，如气管、眼眶、鼻腔、腹膜、鼻窦、脑膜、唾液腺、甲状腺、膈肌、肝脏、胰腺、肺、肾、肾上腺、纵隔、精索、心包、膀胱、前列腺、子宫颈、睾丸、脊髓、骨膜、皮肤、软组织和骨骼。
我们报告一例罕见的原发性气管肿瘤的手术病例。胸部高分辨率计算机断层扫描（HRCT）显示在气管近端三分之一右侧壁有一个5毫米的低密度病变；然而气管腔正常。我们仅出于姑息目的进行了硬质支气管镜检查以切除气管内肿瘤。因此，我们未进行术前组织学检查。该病变用普通活检钳和标准吸引器很容易切除。使用钕钇铝石榴石激光（Nd-YAP）实现肿瘤减容，还使用电灼止血以防止手术期间出血。内镜治疗期间无并发症，患者对该手术耐受性良好。病理诊断为SFT。
位于气管的SFT可通过内镜切除。对于不适合手术切除的临床状况较差（心脏病、呼吸衰竭）的患者，建议采用内镜治疗。
