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伴有严重气道阻塞的气管多形性腺瘤

Tracheal Pleomorphic Adenoma With Severe Airway Obstruction.

作者信息

Kushima Natsumi, Himeji Daisuke, Yanagihara Toyoshi, Maekawa Kazunari, Marutsuka Kousuke

机构信息

Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, JPN.

Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, JPN.

出版信息

Cureus. 2024 Dec 24;16(12):e76341. doi: 10.7759/cureus.76341. eCollection 2024 Dec.

Abstract

Pleomorphic adenoma of the trachea is a rare benign tumor, often challenging to diagnose due to nonspecific symptoms. We report a case of a 72-year-old female with a 10-year history of presumed bronchial asthma, presenting with persistent dyspnea. Preoperative assessment for breast cancer surgery revealed severe obstructive ventilatory impairment. Further investigation with chest CT and bronchoscopy identified an intratracheal nodule, which was successfully resected using electrocautery and cryotherapy via rigid bronchoscopy. Pathological examination confirmed pleomorphic adenoma. Following the intervention, the patient's lung function significantly improved, enabling the planned breast cancer surgery. This case highlights the importance of considering rare tracheal tumors in the differential diagnosis of refractory respiratory symptoms. A review of 11 cases of tracheal pleomorphic adenomas managed by bronchial intervention showed various endoscopic resection techniques, with electrosurgical snaring and argon plasma coagulation being the most common. Our case illustrates the effectiveness of bronchial intervention in managing tracheal tumors with severe airway obstruction and emphasizes the need for thorough preoperative assessment and heightened suspicion for rare tracheal tumors in persistent, treatment-resistant respiratory symptoms.

摘要

气管多形性腺瘤是一种罕见的良性肿瘤,由于症状不具特异性,其诊断往往具有挑战性。我们报告一例72岁女性病例,该患者有10年疑似支气管哮喘病史,表现为持续性呼吸困难。乳腺癌手术的术前评估显示存在严重的阻塞性通气功能障碍。通过胸部CT和支气管镜进一步检查发现气管内有一个结节,经硬质支气管镜使用电灼和冷冻疗法成功将其切除。病理检查确诊为多形性腺瘤。干预后,患者的肺功能显著改善,使得计划中的乳腺癌手术得以进行。该病例凸显了在难治性呼吸道症状的鉴别诊断中考虑罕见气管肿瘤的重要性。对11例经支气管介入治疗的气管多形性腺瘤病例的回顾显示了各种内镜切除技术,其中电圈套器切除和氩等离子体凝固是最常用的。我们的病例说明了支气管介入治疗严重气道阻塞气管肿瘤的有效性,并强调了术前进行全面评估以及对持续性、难治性呼吸道症状高度怀疑罕见气管肿瘤的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a927/11762010/6cb45b916e2a/cureus-0016-00000076341-i01.jpg

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