Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2623
Peer-review started: March 23, 2019
First decision: July 30, 2019
Revised: August 6, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: September 6, 2019
Carcinoma ex pleomorphic adenoma (CXPA) is defined as a malignant salivary gland tumor arising from a primary or recurrent pleomorphic adenoma. Only three cases of CXPA of the trachea have been reported in the literature.
We report a case of tracheal CXPA in a 55-year-old woman, who presented with a more than 3-mo history of progressive dyspnea. Computed tomography of the neck and thorax revealed an inhomogeneous, broad-based lesion arising from the tracheal wall on the right side. Endoscopy revealed a subglottic neoplasm causing up to 90% luminal stenosis. The tumor was resected using a high-frequency electrosurgical snare combined with argon plasma coagulation. Histopathology and immunohistochemistry revealed that the tumor was a CXPA of the trachea.
We report the fourth case of tracheal CXPA, and present the first instance of resection of CXPA using high-frequency electrosurgical snare and laser ablation. We also discuss the pathogenesis, diagnosis, histopathology, and systemic therapy of this rare disease.
Core tip: After extensive search of literature in English, there are only 3 previous reports of primary Carcinoma ex pleomorphic adenoma of the trachea. In our case, there are many unique features. In imaging examination, there is no calcification can be seen in the primary tracheal CXPA of the previous cases, but ours can. Given the rare incidence of CXPA in trachea, no standard systemic therapy options have been established. We successfully performed endobronchial resection of the tumor with a high-frequency electrosurgical snare combined with argon plasma coagulation with less injury and quick recovery.