Chan Ming Chiu, Leung Cheuk Cheung Derek, Chan Yu Hong, Ho Man Ying, Chen Chun Hoi, Ngai Ching Man, Chan Hiu Ching Christy, Yeung Yiu Cheong
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China.
Case Rep Pulmonol. 2024 Oct 16;2024:2961560. doi: 10.1155/2024/2961560. eCollection 2024.
We present a rare case of tracheal schwannoma, the first reported in Hong Kong, emphasizing the diagnostic challenges and treatment outcomes. A 54-year-old woman with respiratory symptoms underwent evaluations revealing a tracheal mass causing luminal narrowing. Emergency operation with rigid bronchoscopy and cryoablation successfully removed the tumor. Follow-up bronchoscopies showed a gradual reduction in residual tumor size, with no evidence of recurrence after 3.5 years postoperation. Tracheal schwannomas are exceedingly rare, often resulting in delayed diagnosis. Clinicians should maintain a high suspicion of tracheal tumors in patients with unexplained respiratory symptoms. Spirometry and flow volume loop analysis aid in identifying upper airway obstruction. Rigid bronchoscopy is preferred for diagnosis and treatment, ensuring airway stability and obtaining tissue samples. Surgical resection remains the mainstay, but observation after endoscopic resection may be considered. This case highlights the successful management of tracheal schwannoma through endoscopic resection and cryoablation, emphasizing the need for further studies and case reports on this rare entity.
我们报告一例罕见的气管神经鞘瘤，这是香港首例报告病例，强调了诊断挑战和治疗结果。一名有呼吸道症状的54岁女性接受评估时发现气管肿物导致管腔狭窄。通过硬质支气管镜检查和冷冻消融进行的急诊手术成功切除了肿瘤。后续的支气管镜检查显示残余肿瘤大小逐渐减小，术后3.5年无复发迹象。气管神经鞘瘤极为罕见，常导致诊断延迟。对于有不明原因呼吸道症状的患者，临床医生应高度怀疑气管肿瘤。肺活量测定和流量容积环分析有助于识别上气道梗阻。诊断和治疗首选硬质支气管镜检查，以确保气道稳定并获取组织样本。手术切除仍然是主要治疗方法，但内镜切除后也可考虑观察。本病例突出了通过内镜切除和冷冻消融成功治疗气管神经鞘瘤，强调了对这一罕见疾病进行进一步研究和病例报告的必要性。
