Tracheal Cancer

Excerpt

Primary tracheal tumors are uncommon but usually malignant in adults, accounting for about 0.2 % of all malignant tumors. The estimated incidence of tracheal cancers is about 0.1 per 100,000 people per year. The largest report of primary tracheal tumors is based on the Surveillance, Epidemiology, and End Results (SEER) database study of 578 cases. In this analysis, 55% were men, and the major histological type was squamous cell carcinoma, accounting for 45% of the cases. Other histologic types include adenoid cystic carcinoma, small cell carcinoma, large cell carcinoma, sarcoma, adenocarcinoma, and carcinoma not otherwise specified or undifferentiated type. Primary tracheal tumors are almost always malignant in adults (up to 90%), whereas, in children, they are only malignant in about 10 to 30% of the cases.

The presenting symptoms are very non-specific and sometimes result in diagnostic delays. These symptoms include shortness of breath, and wheezing, which could mimic benign entities like asthma, chronic obstructive pulmonary diseases, and other reactive airway diseases. Furthermore, not every tumor found in the trachea is a primary tracheal neoplasm. For example, metastatic cancer to paratracheal lymph nodes that invade the trachea may be mistaken for a tracheal primary neoplasm. A thorough radiographic evaluation with histologic correlation can help identify metastatic cancers, which are more common than primary tracheal neoplasms, which are rare. This raises the possibility of primary tracheal tumors being even more uncommon than reported in the general population.