Pleomorphic adenoma of the trachea is a rare benign tumor, often challenging to diagnose due to nonspecific symptoms. We report a case of a 72-year-old female with a 10-year history of presumed bronchial asthma, presenting with persistent dyspnea. Preoperative assessment for breast cancer surgery revealed severe obstructive ventilatory impairment. Further investigation with chest CT and bronchoscopy identified an intratracheal nodule, which was successfully resected using electrocautery and cryotherapy via rigid bronchoscopy. Pathological examination confirmed pleomorphic adenoma. Following the intervention, the patient's lung function significantly improved, enabling the planned breast cancer surgery. This case highlights the importance of considering rare tracheal tumors in the differential diagnosis of refractory respiratory symptoms. A review of 11 cases of tracheal pleomorphic adenomas managed by bronchial intervention showed various endoscopic resection techniques, with electrosurgical snaring and argon plasma coagulation being the most common. Our case illustrates the effectiveness of bronchial intervention in managing tracheal tumors with severe airway obstruction and emphasizes the need for thorough preoperative assessment and heightened suspicion for rare tracheal tumors in persistent, treatment-resistant respiratory symptoms.

Tracheobronchial benign tumors are uncommon; particularly, bronchial pleomorphic adenoma is one of the rarest benign tumors that develop in bronchus (only 7 reported cases, among which only 4 cases of pleomorphic adenoma were seen arising from right main bronchus).

In this report, a 38-year-old woman suffered from progressive shortness of breath for 5 years due to right main bronchial pleomorphic adenoma.

The patient was diagnosed as right main bronchial pleomorphic adenoma based on chest computed tomography enhanced scan, bronchoscopy, and histological examination.

An electrosurgical snare was performed to resect the neoplasm and several APC were administered at the sites of the resection to provide hemostasis and further coagulate for the residual neoplasm.

The patient was free of symptoms and the lumen of right main bronchus was clear during the follow-up period for 10 months without any procedure-related complications.

Bronchial pleomorphic adenoma is extremely rare, however, we should take it into consideration if a patient suffered from shortness of breath without an exact cause.

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

Primary pleomorphic adenomas of the lung are very rare tumors that have peculiar clinical and oncologic features. We report here on the diagnostic and therapeutic approach for a patient with a large neglected pulmonary pleomorphic adenoma that presented initially as pneumonia.