A Case of Primary Tracheal Cancer Localized at the Orfice of the Trachea with Severe Tracheal Stenosis

Abstract

A 74-year-old man was referred due to slight dyspnea in late November 1992. Chest X-ray film showed no abnormal shadow but bronchofiberscopic findings revealed a cauliflower-like tumor arising from posterior wall of the trachea, immediately below the vocal cord. When squamous papilloma was diagnosed, endoscopic Nd-YAG laser therapy was performed after tracheostomy and the tracheal stenosis was opened. However, because of intratracheal recurrence the tumor was resected via the median incision of the trachea, a permanent tracheostomy was done and a T-tube was inserted into the trachea. Pathological examination revealed well differentiated sqamous cell carcinoma of the trachea. After operation the tumor recurred in the trachea twice despite radiation therapy and bilateral intrapulmonary metastasis was detected by chest CT scan. We then performed chemotherapy and radiation therapy simultaneously. This case which was treated by endoscopic laser therapy, operation, irradiation, and chemotherapy during a period of 2 years is the patient alive.