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[Tracheal neurinoma simulating status asthmaticus in a child]
F Brunel1, A Fourmaintraux, J B Mariette
1Service de Pédiatrie, Unité de Réanimation Infantile, Centre Hospitalier Général de Saint-Pierre.
Background:
Neurilemmoma is a benign tumor that is rarely located in the trachea. A neurilemmoma in the intrathoracic part of the trachea can mimic severe status asthmaticus.
Case Report:
A 14 year-old girl was admitted because of persistent signs of status asthmaticus, despite bronchodilator therapy. She had no history of asthma. A worsening of the wheezing while she was in the intensive care unit led to intubation and respiratory support. X-rays showed pneumomediastinum. A dramatic improvement only followed replacement of the intratracheal tube. On the 5th day of the disease, tracheoscopy showed a sessile tumor obstructing two-thirds of the lumen, 3 cm above carena. Biopsy showed the tumor to be a neurilemmoma; it was excised. Scar tissue developed and was responsible for stenosis; it required laser therapy and an endotracheal prosthesis. Neither the girl nor her parents showed signs of neurofibromatosis.
Conclusions:
An intrathoracic tracheal tumor can produce asthmatoid wheezing. A definitive diagnosis can be made only by tracheoscopy.