Primary carcinoma of the trachea: mixed squamous and oat cell type.

Abstract

Primary carcinoma of the trachea is a rare neoplasm. In a combined multicentre series only two primary carcinomas of trachea were found in 47 600 necropsies.1 In 30 years at the Mayo Clinic 47 primary carcinomas of trachea were diagnosed.2 These included 24 squamous carcinomas, which was the commonest histological type, but only two oat cell tumours.We report a case of primary carcinoma of trachea with an unusual mixed histological pattern of oat cell and squamous cell type. This mixed cellular pattern was also seen in varying proportions in metastases at different sites. Case reportThe patient, a 60-year-old man, had had increasing breathlessness on exertion for over six months, which eventually limited his walking to about 270 m on level * ; : < < -. . . . ; . in weight over the six months. At presentation there was faint stridor but no finger clubbing or cervical lymphadenopathy.The chest radiograph was normal but tomography showed the tracheal tumour 5 cm above the main carina and a right-sided paratracheal mass which later proved to be a lymph node containing metastatic tumour.At thoracotomy, the tracheal tumour was removed in continuity with the enlarged, paratracheal nodes and the defect repaired with a pericardial patch. Staphylococcal bronchopneumonia developed on the third postoperative day and, despite intensive treatment, the patient died 18 days after operation.