Akut aufgetretene Dyspnoe im Rahmen eines primären Pleomorphen Adenoms der Trachea

Introduction:

A 68-year-old woman presented at our interdisciplinary emergency department with acute dyspnea, expiratory stridor and suspected upper airway infection. She had been complaining of intermittent symptoms of a similar but milder nature for about 2 years and had been diagnosed with asthma. On auscultation, the internal medicine colleagues described an abnormal breath sound. However, an ENT consultation revealed a subglottic mass. The pulmonologists performed an emergency endoscopic ablation of thetracheal tumor by kryotherapy.

Methods:

We performed an extensive literature research on Pudmed, completed a detailed photo and video documentation of the endoscopiccryoablation and took a closer look at the histological results.

Results:

The histology of the emergency bronchoscopy with cryo-ablation revealed a typical pattern of a pleomorphic adenoma. After removal of the vessel-injected mass from the posterior tracheal wall, there was no more dyspnoea. In the current literature only 40 case reports of primary pleomorphic adenoma of the trachea can be found.

Discussion:

Pleomorphic adenoma is one of the rarest neoplasms in the trachea. Asthma was the initial misdiagnosis in another case report of the literature. In the absence of seasonal symptoms, further consultation or imaging should be performed. Primary tumors of the trachea are rare and are more likely to be malignant, e.g. squamous cell carcinoma or adenoid cystic carcinoma.

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