Seven-Year Survival of a Patient with Primary Tracheal Squamous Cell Carcinoma after Surgery: A Case Report

Document Type: Case Report

Authors

1 Thoracic surgeon, Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Resident of General Surgery, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Resident of General Surgery,Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

The primary tracheal cancers are very rare, and squamous cell carcinoma is its most common form, especially in smokers. Due to the late presentation of symptoms, these tumors are usually diagnosed too late, and thus, they have poor survival. The gold standard protocol for these cancers is surgical excision and adjuvant radiotherapy. Primary radiotherapy is applied for the advanced and inoperable patients.
In this study, we present the case of a 78-year-old woman with a history of heavy smoking, coughing, and dyspnea for a long time. During the diagnostic evaluations, bronchoscopy was carried out and a vegetated tumor was observed about 5 cm below the vocal cords. The patient was referred to the Department of Cardiothoracic Surgery, Ghaem Hospital of Mashhad University of Medical Sciences, Iran, for surgical management. The tumor was removed with rigid bronchoscopy, and her dyspnea temporarily improved. The pathology report indicated that the patient was suffering from squamous carcinoma. Therefore, she required reoperation to excise the invaded trachea with a tumor-free margin. Ultimately, considering no marginal involvement, lymphatic metastasis, or distant metastasis, the patient was discharged and referred to receive additional oncological treatments with the recommendation of annual surveillance bronchoscopy. Seven years after the operation, the patient is still alive and healthy without any local recurrence or metastasis at the age of 82.

Keywords


1.Abbate G, Lancella A, Contini R, Scotti A. A primary squamous cell carcinoma of the trachea: case report and review of the literature. Acta Otorhinolaryngol Ital. 2010; 30:209-12
2. Webb BD, Walsh GL, Roberts DB, Sturgis EM. Primary tracheal malignant neoplasms: the University of Texas MD Anderson Cancer Center experience. J Am Coll Surg. 2006; 202:237-46
3. Schneider P, Schirren J, Muley T, Vogt-Moykopf I. Primary tracheal tumors: experience with 14 resected patients. Eur J Cardiothorac Surg. 2001; 20:12-8.
4. Honings J, Gaissert HA, Ruangchira-Urai R, Wain JC, Wright CD, Mathisen DJ, et al. Pathologic characteristics of resected squamous cell carcinoma of the trachea: prognostic factors based on an analysis of 59 cases. Virchows Arch. 2009; 455:423-9.
5. Li W, Ellerbroek NA, Libshitz HI. Primary malignant tumors of the trachea. A radiologic and clinical study. Cancer. 1990; 66:894-9.
6. Thotathil ZS, Agarwal JP, Shrivastava SK, Dinshaw KA. Primary malignant tumors of the trachea - the Tata Memorial Hospital experience. Med Princ Pract. 2004; 13:69-73.
7. Gaissert HA, Grillo HC, Shadmehr MB, Wright CD, Gokhale M, Wain JC, et al. Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina. Ann Thorac Surg. 2004; 78:1889-96.
8. Hermes C, Grillo MD. Primary tracheal neoplasms. In: Grillo HC, editor. Surgery of the trachea and bronchi. London: BC Decker Inc; 2004. P. 207-8.
9. Li ZJ, Tang PZ, Xu ZG. Experience of diagnosis and treatment for primary cervical tracheal tumours. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006; 41:208-10.
10. Ahn Y1, Chang H, Lim YS, Hah JH, Kwon TK, Sung MW, et al. Primary tracheal tumors: Review of 37 cases. J Thorac Oncol. 2009; 4:635-8.