Tracheal Neoplasms in Children

Abstract

Primary tracheal neoplasms are extremely rare lesions in the pediatric age group. This study reviews the English-language literature to better characterize these lesions in children and reports 2 additional patients. Reports of only 36 infants and children through adolescence with primary tracheal neoplasms were discovered after an exhaustive literature review of the last 30 years. The data are analyzed with regard to pathology, demographics, symptomatology, site, and percent luminal obstruction. We report 2 additional patients with photographic documentation, imaging studies, and histopathology. Of the 36 previously reported lesions, 64% were characterized as benign and 36% as malignant. Fifty-six percent of all lesions were initially misdiagnosed as asthma. The most common site was the posterior membranous wall of the cervical trachea. In 14 (39%) of the 36 patients, the lesions obstructed more than 50% of the lumen at the time of diagnosis. The timely diagnosis of tracheal masses depends upon maintaining a high index of suspicion and conducting an efficient workup, including definitive evaluation by bronchoscopy. The evaluation and the differential diagnosis of tracheal neoplasms in the pediatric population is discussed.

Primary major airway tumors; management and results

“…In our patients, benign tumors were seen more in younger patients as observed by others [1,4]. However, in young patients, we have to keep the malignant tumors in our differential diagnosis as we had four carcinoids and three other types of malignant tumors in patients younger than 20 years old.…”

“…They are usually malignant in adults, but benign in children [4]. The most common histologic types are squamous cell carcinoma (SCC) and adenoidcystic carcinoma (ACC), which account for about 2/3 of these tumors [3,5,6].…”

Tracheal juvenile xanthogranuloma in a child

“…The previous reported case, diagnosed as subglottic JXG, showed the same pattern of development. In a series of 36 children presenting tracheal tumors, 56% were initially misdiagnosed as having asthma [17]. Although rare, a tracheal tumor needs to be considered in the diagnosis of stridor and wheezing in children, and further investigation is required when medical therapy has proved ineffective.…”

Childhood granular cell tumors: Two case reports

“…Tracheal lesions are multifocal in 20% of cases [1,19], suggesting that multiple sites of involvement may be more frequently seen in the respiratory tree.…”