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Tracheal pleomorphic adenoma with coexisting pulmonary tuberculoma

  • Kim, Jehun (Department of Pulmonary and Critical Care Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Oak, Chul-Ho (Department of Pulmonary and Critical Care Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Jang, Tae-Won (Department of Pulmonary and Critical Care Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Jung, Mann-Hong (Department of Pulmonary and Critical Care Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine)
  • Received : 2017.09.30
  • Accepted : 2017.11.14
  • Published : 2018.06.30

Abstract

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

Keywords

References

  1. Park KS, Sung WJ. Pleomorphic adenoma of the trachea: a case report. Korean J Pathol 2013;47:399-401. https://doi.org/10.4132/KoreanJPathol.2013.47.4.399
  2. Ashwaq AM, Sani A. Pleomorphic adenoma of the trachea. Med J Malaysia 2007;62:162-3.
  3. Chowdhury Q, Rahman MA, Sultana L, Islam MA, Chowdhury GM. Tracheal adenocarcinoma treated with adjuvant radiation: a case report and literature review. Case Rep Oncol 2013;6:280-4. https://doi.org/10.1159/000351736
  4. Pinkston JA, Cole P. Incidence rates of salivary gland tumors: results from a population-based study. Otolaryngol Head Neck Surg 1999;120:834-40. https://doi.org/10.1016/S0194-5998(99)70323-2
  5. Spencer H. Bronchial mucous gland tumours. Virchows Arch A Pathol Anat Histol 1979;383:101-15. https://doi.org/10.1007/BF00427013
  6. Moran CA, Suster S, Askin FB, Koss MN. Benign and malignant salivary gland-type mixed tumors of the lung. Clinicopathologic and immunohistochemical study of eight cases. Cancer 1994;73:2481-90. https://doi.org/10.1002/1097-0142(19940515)73:10<2481::AID-CNCR2820731006>3.0.CO;2-A
  7. Ang KL, Dhannapuneni VR, Morgan WE, Soomro IN. Primary pulmonary pleomorphic adenoma. An immunohistochemical study and review of the literature. Arch Pathol Lab Med 2003;127:621-2.
  8. Payne WS, Schier J, Woolner LB. Mixed tumors of the bronchus (salivary gland type). J Thorac Cardiovasc Surg 1965;49:663-8.
  9. Matsubara M, Yasuo M, Tanabe T, Tsushima K, Urushihata K, Yamamoto H, et al. Pleomorphic adenoma with an endobronchial resection. Intern Med 2008;47:1117-20. https://doi.org/10.2169/internalmedicine.47.0853
  10. Tanigaki T, Shoyama Y, Iwasaki M, Abe Y, Nakamura M, Inoue H. Pleomorphic adenoma in the lung. Monaldi Arch Chest Dis 2002;57:30-2.
  11. Fitchett J, Luckraz H, Gibbs A, O'Keefe P. A rare case of primary pleomorphic adenoma in main bronchus. Ann Thorac Surg 2008;86:1025-6. https://doi.org/10.1016/j.athoracsur.2008.02.073
  12. Aribas OK, Kanat F, Avunduk MC. Pleomorphic adenoma of the trachea mimicking bronchial asthma: report of a case. Surg Today 2007;37:493-5. https://doi.org/10.1007/s00595-006-3441-0
  13. Schneider P, Schirren J, Muley T, Vogt-Moykopf I. Primary tracheal tumors: experience with 14 resected patients. Eur J Cardiothorac Surg 2001;20:12-8. https://doi.org/10.1016/S1010-7940(01)00732-1
  14. Goto T, Maeshima A, Akanabe K, Hamaguchi R, Wakaki M, Oyamada Y, et al. Bronchial pleomorphic adenoma coexisting with lung cancer. Ann Thorac Cardiovasc Surg 2011;17:174-7. https://doi.org/10.5761/atcs.cr.09.01516
  15. Demirag F, Topcu S, Kurul C, Memis L, Altinok T. Malignant pleomorphic adenoma (malignant mixed tumor) of the trachea: a case report and review of the literature. Eur Arch Otorhinolaryngol 2003;260:96-9.
  16. Shim TS. Diagnosis and treatment of latent tuberculosis infection. Korean J Med 2012;82:284-90. Korean. https://doi.org/10.3904/kjm.2012.82.3.284

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  1. Obstructive tracheal neoplasm: Imaging and therapeutical features of pleomorphic adenoma vol.52, pp.3, 2018, https://doi.org/10.4103/fjs.fjs_65_18
  2. Pleomorphic adenoma of the trachea: A case report and review of the literature vol.8, pp.23, 2018, https://doi.org/10.12998/wjcc.v8.i23.6021