Multidisciplinary management of tracheal paraganglioma with angiographic embolization and surgical excision: A case report and review of literature.

RATIONALE

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.

PATIENT CONCERNS

We present the case of a 58-year-old female initially diagnosed with asthma who later experienced recurrent hemoptysis and worsening dyspnea.

DIAGNOSES

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.

INTERVENTIONS

To prevent excessive bleeding, angiographic embolization was performed before bronchoscopic surgical resection, involving super-selective catheterization of the tumor's arterial feeder.

OUTCOMES

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.

LESSONS

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.