Jalili Javad, Amiri AhmadReza, Rasi Hashemi Seyed Ziyaeddin, Rezaei Sahar, Mikaeeli Mohammadreza, Karbasi Mahsa, Vaseghi Sarah
Department of Interventional Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.
Medicine (Baltimore). 2025 Aug 1;104(31):e42712. doi: 10.1097/MD.0000000000042712.
Tracheal paragangliomas (PGs) are exceedingly rare tumors originating from chromaffin cells. They often present with nonspecific symptoms like dyspnea and hemoptysis, which can mimic more common respiratory conditions such as asthma.
We present the case of a 58-year-old female initially diagnosed with asthma who later experienced recurrent hemoptysis and worsening dyspnea.
Rigid bronchoscopy revealed a vegetative mass located 2 cm below the vocal cords, and a biopsy confirmed PG. Cross-sectional imaging identified a lobulated lesion on the posterior tracheal wall.
To prevent excessive bleeding, angiographic embolization was performed before bronchoscopic surgical resection, involving super-selective catheterization of the tumor's arterial feeder.
The embolization successfully reduced vascularity, facilitating safe tumor resection. The patient remains symptom-free at the 1-year follow-up, indicating effective management of the condition.
This case highlights the importance of a multidisciplinary approach in diagnosing and treating tracheal PGs. Preoperative embolization is crucial for managing bleeding risks associated with these highly vascular tumors. Detailed insights into the angiographic procedure are provided, along with a systematic review of similar cases.
气管副神经节瘤（PGs）是起源于嗜铬细胞的极其罕见的肿瘤。它们常表现为呼吸困难和咯血等非特异性症状，可类似于哮喘等更常见的呼吸系统疾病。
我们报告一例58岁女性病例，该患者最初被诊断为哮喘，后来反复咯血且呼吸困难加重。
硬质支气管镜检查发现声门下2 cm处有一赘生物，活检确诊为PG。横断面成像显示气管后壁有一分叶状病变。
为防止过度出血，在支气管镜手术切除前进行了血管造影栓塞，包括对肿瘤供血动脉进行超选择性插管。
栓塞成功减少了血管供应，便于安全切除肿瘤。患者在1年随访时无症状，表明病情得到有效控制。
该病例强调了多学科方法在气管PGs诊断和治疗中的重要性。术前栓塞对于管理与这些高血管性肿瘤相关的出血风险至关重要。提供了血管造影手术的详细见解，并对类似病例进行了系统回顾。
