Optimal treatment for primary benign intratracheal schwannoma: A case report and review of the literature

Abstract

Abstract.A 53-year-old male was admitted to Xinhua Hospital (Shanghai, China) due to coughing and dyspnea that had persisted for half a year, with aggravation of chest tightness and dyspnea for 1 week. Chest computed tomography (CT) revealed a mass within the distal third of the trachea. Flexible bronchoscopy confirmed an ~2.0 cm, smooth, tan-colored mass in the trachea, 2 cm above the carina. Endoscopic resection by argon plasma coagulation combined with electronic snaring was applied, however, recurrence was found 2 weeks later. Finally, the tumor was completely removed by surgery and the post-operative course was uneventful. Since schwannoma is rare in the intrapulmonary region and extremely rare in the trachea, a review of 51 cases of primary tracheal schwannoma previously reported in the English literature was performed. The majority of cases occurred in adults and were usually located in the distal third of the trachea. The predominant tumor size was 1-3 cm and airway obstruction symptoms were common. Half of the patients were misdiagnosed with asthma, and CT scan and bronchoscopy were contributory to the correct diagnosis. The treatment of choice depended on the patient's condition, however, surgery should be chosen in the event of local recurrence following endoscopic treatment.

Primary tracheal schwannoma a review of a rare entity: current understanding of management and followup

“…Primary tracheal neurogenic tumors are extremely rare. These tumors include mainly the benign peripheral nerve sheath tumors: neurofibroma and schwannoma [ 3 , 4 ] and to date, there are only two reported cases of primary malignant endotracheal nerve sheath tumors [ 5 , 6 ]. Schwannomas are extremely rare in the trachea, being more frequently reported in the lungs and bronchi [ 6 ].…”

“…Tracheal schwannoma was first reported in 1951 [ 7 ]. They are usually solitary, well-encapsulated lesions that are attached to the nerve sheath and sometimes covered with several small, discrete vessels [ 3 , 6 , 8 , 9 ]. It is rarely associated with von Recklinghausen disease and also the malignant transformation is extremely rare [ 3 , 8 ].…”

“…In the published literature that describes this rare disease there are 4 successive prominent case reports with review of the literature in which the newer review includes the older reported cases [ 4 – 6 , 8 ]. These reports are summarized in Table 1 .…”

“…In the study that reviewed the literature between 1950 and 2013, only 51 cases of primary tracheal schwannoma were identified in the English literature [ 6 ]. In addition to these cases, a recent case has been also reported [ 11 ].…”

Rare airway tumors: an update on current diagnostic and management strategies

“…Other treatment such as chemotherapy, radiotherapy and anti-inflammatory drugs may be used in conjunction with surgical or endoscopic management or as palliation for patient who have tumors that are candidates for endoscopic or surgical management (3,4,6,7,9,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). A summary of most employed treatment modalities for rare airway tumors is provided in Table 4 (26,32,36,47,49,(58)(59)(60)(62)(63)(64)(65)(66)(67).…”