Tracheal Chondrosarcoma: Systematic Review of Tumor Characteristics, Diagnosis, and Treatment Outcomes with Case Report

Abstract

To our knowledge this is the first systematic review of tracheal chondrosarcoma treatment outcomes. Management insights are thoroughly discussed. Men constitute 93.8% of cases, and most of these occur in the distal trachea. The most common symptom, dyspnea, occurs in virtually all patients. Extratracheal extension had occurred in 78.6% of patients. Definitive treatment with tracheal resection showed no recurrences in 10 patients with mean follow-up of 3.1 years. Adjuvant radiotherapy may be utilized for improving local control when open complete resection cannot be performed, but only after endoscopic excision of gross tumor.

Tracheal chondrosarcoma and surgical management

“…4 It is an indolent tumor affecting more males than females (8:1) at a mean age of 65 years. 4 The most frequent symptom is dyspnea, 5 and the duration of symptoms is >15 months. 4 These tumors are unlikely to metastasize but give rise to a prolonged history, presenting as large calcified tumors that obstruct more than 75% of the lumen; 5 the obstruction was almost complete in our patient (90% of the lumen).…”

“…4 The most frequent symptom is dyspnea, 5 and the duration of symptoms is >15 months. 4 These tumors are unlikely to metastasize but give rise to a prolonged history, presenting as large calcified tumors that obstruct more than 75% of the lumen; 5 the obstruction was almost complete in our patient (90% of the lumen). Predominantly, tracheal tumors emerge from the posterior and lateral walls, with 60% located in the inferior third, 27% in the superior third, and 20% in the middle third, 2 as in our case.…”

“…According to Kutzner and colleagues, 5 complete resection of the trachea with reconstruction gives optimal results; recurrence is the most feared complication. We opted for a staged procedure in this case: emergency laser debridement of the tumor followed by elective resection.…”

“…4 Low-grade chondrosarcoma is unresponsive to chemotherapy; 7 chemotherapy is reserved for high-grade tumors with a greater risk of metastasis. 5 The role of radiotherapy in chondrosarcomas is controversial, partly due to their low-grade nature and excellent prognosis with cure rates of 75%–85% and rare distant dissemination. 8 However, recent reports suggest the use of radiotherapy for head and neck chondrosarcoma as adjuvant treatment.…”

Tracheobronchial Tumors: Radiologic–Pathologic Correlation of Tumors and Mimics

“…They tend to be low grade with a low risk of metastasis. The treatment of choice is surgical resection [29][30][31] (Fig 7).…”