Beware of tracheal obstruction due to polyps.

SGGPO 22/03/2023 11:50

Tracheal tumors are a rare clinical condition. Their clinical symptoms are very similar to asthma, making diagnosis difficult and easily overlooked.

On March 22, Military Hospital 175 (Ministry of National Defense) announced that doctors from the Tuberculosis and Lung Disease Department had successfully removed a tumor obstructing the trachea, saving the life of a 17-year-old female patient, NNT (from Binh Thuan province ), who was suffering from a large polyp causing critical respiratory failure due to tracheal obstruction.

The patient was admitted with a respiratory tract infection (cough, sputum production, shortness of breath), and had received treatment at a local hospital, but the symptoms did not improve and subsequently worsened, leading to respiratory failure. Upon admission, examination revealed critical respiratory failure due to a large tracheal tumor.

The patient was immediately intubated and placed on mechanical ventilation and received intensive care. A CT scan and tracheal tree reconstruction revealed a large tumor measuring 3x2 cm causing tracheal obstruction.

The patient subsequently underwent a tracheostomy below the narrowed segment and flexible bronchoscopy, revealing a large tumor located just below the vocal cords with a base attached to the posterior tracheal wall. The surface was smooth and highly vascularized, causing almost complete tracheal obstruction. Histopathological examination of the tumor yielded results consistent with a fibrous epithelial polyp.

According to Dr. Nguyen Hai Cong, Head of the Department of Tuberculosis and Lung Diseases at Military Hospital 175 , large tumors in the trachea and bronchi are usually surgically removed. However, this is a highly invasive procedure and can leave sequelae for the patient. Because the patient was young and the tumor was benign, the team decided to perform endoscopic resection via flexible bronchoscopy to minimize the risk of airway damage.

The patient was examined and scheduled for endoscopic transbronchial resection of the tumor via radiofrequency ablation under intravenous anesthesia. The resection process was successful, and the tumor was completely removed after 60 minutes of intervention. The patient received antibiotic treatment and corticosteroids to reduce inflammation after the procedure.

The patient was weaned off the ventilator after 5 days, the tracheostomy was closed, and the patient was discharged. Currently, the patient is free from shortness of breath, has normal physical activity, and follow-up bronchoscopy at 2 and 6 months showed only a small, flat scar on the mild bronchial mucosa at the resection site and no signs of tumor recurrence.

"This is a very rare case and has been successfully treated using radiofrequency ablation via flexible bronchoscopy at the hospital. The patient is now completely stable and participating in normal learning and physical activities," informed Dr. Nguyen Hai Cong.

According to Dr. Nguyen Hai Cong, benign tracheal tumors are rare, estimated to account for less than 2% of all airway lesions. Early diagnosis is often difficult due to vague symptoms that are frequently overlooked.

These lesions are usually small tumors in the trachea and bronchi, and large tumors causing airway obstruction are very rare. Fibrous epithelial polyps are a common type of benign tumor of the skin or mucous membranes of the genital tract, but are very rare in the trachea. They can be solitary or multiple, and their size usually does not exceed 5 mm.

Source: https://www.sggp.org.vn/coi-chung-bit-tac-khi-quan-do-polyp-post682933.html