Beware of tracheal obstruction due to polyps

SGGPO 03/22/2023 11:50

Tracheal tumors are a rare clinical disease. Clinical symptoms are very similar to bronchial asthma, so diagnosis is often difficult and easy to miss.

On March 22, Military Hospital 175 (Ministry of National Defense) announced that doctors from the Tuberculosis and Lung Disease Department had just removed a tumor blocking the trachea, saving the life of a female patient NNT (17 years old, living in Binh Thuan) with a large polyp causing critical respiratory failure due to tracheal obstruction.

The patient was admitted to the hospital with a respiratory infection (cough, phlegm, difficulty breathing), and was treated at a local hospital but the symptoms did not improve, then progressed to severe respiratory failure. Upon admission, through examination, the patient was diagnosed with critical respiratory failure due to a large tracheal tumor.

Immediately, the patient was intubated and given mechanical ventilation and intensive resuscitation. As a result, CT scan and tracheal reconstruction revealed a large tumor structure measuring 3x2 cm causing tracheal stenosis.

The patient then underwent a tracheostomy below the stenosis and a flexible bronchoscopy, which revealed a large tumor located just below the vocal cords with a base attached to the posterior wall of the trachea. The surface was smooth and had many surface blood vessels, causing almost complete obstruction of the trachea. When the tumor was biopsied for histopathological examination, the histopathological results were consistent with fibrous epithelial polyps.

Dr. Nguyen Hai Cong, Head of the Department of Tuberculosis and Lung Diseases, Military Hospital 175, said that normally, large tumors in the trachea and bronchus will be surgically removed. However, this is a highly invasive intervention method and can leave sequelae for the patient. Because the patient is young and the tumor is benign, the team decided to perform endoscopic bronchoscopy to minimize the risk of damage to the patient's airway.

The patient was consulted and indicated to perform endotracheal tumor resection technique using high frequency electric bronchoscopy under intravenous anesthesia. The resection process went smoothly, the tumor was completely removed after 60 minutes of intervention. The patient was treated with antibiotics and anti-inflammatory corticosteroids after the intervention.

The patient was weaned off the ventilator after 5 days, the tracheostomy was closed and he was discharged. The patient is now no longer having difficulty breathing and is able to perform normal physical activities. At the same time, bronchoscopy re-examination after 2 and 6 months showed only a small, flat scar in the bronchial mucosa at the resection site and no signs of tumor recurrence.

“This is a very rare case and has been successfully treated by high-frequency electrical ablation intervention through flexible bronchoscopy at the hospital. The patient is now completely stable in health and participates in normal learning and exercise activities,” informed Dr. Nguyen Hai Cong.

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

These lesions are usually small tumors in the trachea and bronchi, and very rarely large tumors that cause airway obstruction. Fibroepithelial polyps are a type of benign tumor that is common in 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