Primary tumors of the trachea. Clinicopathologic features and surgical results

We studied 16 patients with primary malignant tracheal tumors, including five epidermoid, five adenoid cystic, and two mucous gland carcinomas; and two fibrosarcomas, one carcinoid tumor, and one plasmacytoma. The tumors were more frequently located in the lower third of the trachea, and the most common symptom was dyspnea. Nine patients underwent surgery consisting of circumferential resection of the involved trachea with end-to-end anastomosis in eight and prosthetic replacement in the remaining. In only one case was combined radiotherapy given. Surgery was successful where the tumor was well circumscribed and where the resected segment comprised no more than half of the length of the trachea. Tumors of the trachea are locally invasive. The disease, when extensive, involved the neck or mediastinal structures. This indicates that early diagnosis in these patients is of paramount importance. Extratracheal extension should be ruled out before surgery is attempted. We believe that palliative surgery of the trachea should be avoided, and tomography and endoscopy should be done as a routine procedure in patients with unexplained dyspnea and normal chest x-ray results to rule out a tracheal tumor.