Successful cryotherapy of a benign tracheal neoplasm

A 10-year-old black male with a 6-month history of progressive dyspnea and stridor was found to have a submucosal mass occupying 75% of the subglottic airway. Biopsy specimens showed a pleomorphic adenoma of minor salivary gland origin--a tumor with a predilection for local recurrence after resection. A tracheostomy was performed for airway control and the lesion was treated with endotracheal cryotherapy. Two months later, the tracheostomy was removed and the patient has remained asymptomatic for 9 years. Pulmonary function studies 2 years following cryotherapy demonstrated a forced vital capacity (FVC) of 81% predicted, and a forced expiratory volume-one second (FEV-1) of 73% predicted. Bronchoscopy with biopsy at 5 years showed no evidence of recurrent airway obstruction or persistent tumor. This represents the first reported case of successful treatment of an airway tumor in a child utilizing profound cryotherapy. The case illustrates the utility of endotracheal cryotherapy in the treatment of certain benign and malignant obstructing lesions of the airway in children.