tracheal tumor

Introduction

Introduction to tracheal tumor There are two major types of tracheal tumors: benign tumors and malignant tumors. The primary tumors of the trachea are rare. The primary malignant tumors of the upper respiratory tract account for about 1% of all malignant tumors. The incidence of different sites is not consistent: the incidence on the glottic is 1.3. 100/100, the glottis is 2.3/100,000, but the glottis and trachea are only 0.04/100,000. Primary malignant tumors account for 0.1-0.4% of all malignant tumors, and the number of new cases is about 2.6/100,000 per year, of which 8% occur in children. Therefore, most of the tracheal tumors in adults are malignant (malignant accounted for 90%), and children with benign tumors (malignant accounted for 10-30%). Surgical treatment is the first treatment for tracheal tumors. Patients with feasible surgical resection have better prognosis than patients who cannot undergo surgery. Therefore, the principle of treatment is surgical resection of patients with localized lesions, and postoperative follow-up observation of local recurrence and distant metastasis. basic knowledge The proportion of illness: this disease is rare, the incidence rate is about 0.0002%-0.0004% Susceptible people: no special people Mode of infection: non-infectious Complications: upper airway obstruction, swallowing difficulties, tracheoesophageal fistula

Cause

Tracheal tumor etiology

Most of the primary tracheal malignant tumors grow at the junction of the cartilage ring and the membrane. The squamous cell carcinoma can be a mass that protrudes into the trachea or ulceration. Sometimes the cancer can infiltrate the long trachea. In advanced cases, the mediastinal lymph nodes are often present. Metastasis or spread into the lung tissue, and can directly invade the esophagus, recurrent laryngeal nerve and throat. Cystic adenoid carcinoma generally grows slowly, metastasizes later, sometimes presents with long submucosal infiltration or growth into the mediastinum, and some tumors It is dumbbell-shaped, with a small portion protruding into the tracheal lumen, mostly in the mediastinum, and advanced cases can invade the mediastinum and bronchi.

Primary airway benign tumors have many types and different forms. In most tumors, the growth is slow, the surface is smooth, the mucosa is intact, and there are often tumor pedicles, no metastasis, but if the resection is not complete and easy to relapse, papilloma often occurs in the trachea. Department, protruding into the bottom of the tracheal cavity, often with fine pedicles, ranging in size from a few millimeters to 2cm, sometimes multiple, the surface is scorpion-like, soft and brittle and easy to fall off, bleeding when ruptured.

Prevention

Tracheal tumor prevention

For primary tracheal tumors, early diagnosis, early treatment, different appropriate treatments for different patients, combined with the surgeon's excellent skills and sense of responsibility, the treatment effect of the disease is satisfactory.

Complication

Tracheal tumor complications Complications upper airway obstruction, difficulty swallowing, tracheoesophageal fistula

1, airway obstruction

Because the early symptoms are not typical, and the main manifestations are cough, cough, wheezing, or a little blood in the sputum, can not get the correct diagnosis in time, the tumor volume grows up the airway, affecting the breathing, if not treated in time, the condition can be It is very dangerous to develop, and it is easy for patients to die easily.

2, in the case of malignant tumors, advanced cases may present hoarseness, difficulty swallowing, compression of mediastinal organs and other symptoms, and complications of tracheal esophageal fistula, cervical lymph node metastasis and pulmonary purulent infection.

Symptom

Tracheal tumor symptoms Common symptoms Dysphagia, hoarseness, bloodshot, bronchial tree, compression, sputum, bloodshot, shortness of breath, dryness, cough, sputum, dyspnea, cough

Most of the primary tracheal malignant tumors grow at the junction of the cartilage ring and the membrane. The squamous cell carcinoma can be a mass that protrudes into the trachea or ulceration. Sometimes the cancer can infiltrate the long trachea. In advanced cases, the mediastinal lymph nodes are often present. Metastasis or spread into the lung tissue, and can directly invade the esophagus, recurrent laryngeal nerve and throat. Cystic adenoid carcinoma generally grows slowly, metastasizes later, sometimes presents with long submucosal infiltration or growth into the mediastinum, and some tumors It is dumbbell-shaped, with a small portion protruding into the tracheal lumen, mostly in the mediastinum, and advanced cases can invade the mediastinum and bronchi.

Primary airway benign tumors have many types and different forms. In most tumors, the growth is slow, the surface is smooth, the mucosa is intact, and there are often tumor pedicles, no metastasis, but if the resection is not complete and easy to relapse, papilloma often occurs in the trachea. Department, protruding into the bottom of the tracheal cavity, often with fine pedicles, ranging in size from a few millimeters to 2cm, sometimes multiple, the surface is scorpion-like, soft and brittle and easy to fall off, bleeding when ruptured.

The clinical symptoms of tracheal tumors vary according to the size and nature of the tumor. Common early symptoms are irritating cough, sputum or innocence, and sometimes bloodshot. When the tumor grows and blocks the tracheal cavity more than 50%, it appears. Shortness of breath, difficulty breathing, wheezing, etc., often misdiagnosed as bronchial asthma and delayed treatment. Late cases of tracheal malignant tumors may present hoarseness, difficulty swallowing, tracheoesophageal fistula, mediastinal organ tissue compression, cervical lymph node metastasis and lung suppuration Sexual infection and other symptoms.

Examine

Tracheal tumor examination

1, tracheal tomography examination can show the location of the tumor and the extent of tracheal stenosis.

2, tracheal lipiodol imaging is also very valuable for the diagnosis of tracheal tumors, but there is a risk of increased tracheal obstruction, only for cases with less obstructive.

3, endoscopy can directly see the tumor, understand the location, size, surface morphology and activity of the tumor, and can take tissue for pathological biopsy to determine the nature and type of tumor.

4, for benign tumors with intact mucosa and rich blood vessels, it is not appropriate to routinely perform biopsy to avoid causing massive bleeding.

Diagnosis

Tracheal tumor diagnosis and differentiation

Tracheal tumors are not too common in clinical practice, accounting for about 1% of primary tumors in the respiratory tract. Most of the pathological types are squamous cell carcinoma or cystadenocarcinoma, because the symptoms of early cancer are atypical, and the non-specialist is often misdiagnosed. The reasons for misdiagnosis are as follows:

1, tracheal tumor onset attack, early symptoms are not typical, and mainly manifested as cough, cough, asthma, or a little blood in the sputum, often treated as a cold, when the cough is intensified, blood stasis, was misdiagnosed as tuberculosis, Bronchitis, bronchiectasis, etc., when the tumor grows up has blocked the tracheal cavity more than 50%, there are more typical symptoms such as shortness of breath, difficulty breathing, wheezing, etc., and often misdiagnosed as bronchial asthma.

2, because non-specialist doctors do not know enough about this disease, often until the tumor is significantly enlarged, occupying the airway, affecting the breathing is only taken seriously.

3, the physician relies too much on auxiliary examinations such as chest filming, because tracheal shadows are often blocked by the mediastinum and cause missed diagnosis.

Therefore, clinicians should be alert to the disease, irritating dry cough, or with white foam sputum, sputum with blood spots, bloodshot, shortness of breath, difficulty breathing, asthma can not be relieved with anti-asthma drugs, should be Considering the possibility of this disease, further examination is necessary to confirm or exclude. Tracheal angiography is also valuable for the diagnosis of tracheal tumors, but it has the risk of aggravating tracheal obstruction and is only used in cases with less obstruction.

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