Pleomorphic Adenoma of the Trachea

Abstract

A 27-year-old male smoker went to his family physician with a nonproductive cough and low-grade fever of several days' duration. In addition, he reported having dyspnea on exertion and intermittent wheezing for at least 1 year. A chest x ray revealed a mass in the distal trachea. Subsequent computed tomography (CT) of the chest demonstrated a 2.5-cm mass in the trachea at the level of the aortic arch, which occupied approximately 60% of the tracheal lumen. CT did not reveal any extratracheal spread or mediastinal adenopathy.The patien t was referred to Indiana University Medical Center where bronchoscopy confirmed a 2.5cm tracheal mass located 2 cm above the carina. The mass was smooth, firm, and white, and had prominent telangiectasia on its surface (Fig. 1). A biopsy revealed pleomorphic adenoma.Th e patient subsequently underwent definitive surgical resection, which included suprahyoid laryngeal release, tracheal mobilization, and tracheal resection with primary anastomosis performed through a right thoracotomy. Surgical margins were clear, and the tumor was confined to the trachea. The patient is asymptomatic and doing well 6 months after surgery.