Airway Tumors

Primary tracheal tumors are rare (0.1/100,000 people). They are often malignant and found at a locally advanced stage. The most common malignant tracheal tumors include adenoid cystic carcinoma, squamous cell carcinoma, carcinoid, and mucoepidermoid carcinomas. The most common benign airway tumor is a squamous papilloma, although pleomorphic adenomas and granular cell and benign cartilaginous tumors also occur.

Symptoms, Signs, and Diagnosis

Patients often present with dyspnea, cough, wheezing, hemoptysis, and stridor. Hemoptysis occurs with squamous cell carcinoma and can lead to earlier diagnosis, whereas wheezing or stridor occurs more often with the adenoid cystic variant. Dysphagia and hoarseness can also be present initially and usually indicate advanced disease.

Symptoms of airway narrowing can herald life-threatening airway obstruction and require immediate hospitalization and evaluation with bronchoscopy. Bronchoscopy can both stabilize the airways and obtain specimens for diagnosis. If a malignancy is found, more extensive testing for metastases is done.