Case Reports
Inflammatory pseudotumor of the trachea

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Abstract

Primary tracheal tumors are extremely rare, and the majority of them are malignant. Inflammatory pseudotumor is a benign, tumorlike lesion, most likely of a reactive nature. Its basic morphologic characteristic is spindle cell (myoblasts and fibroblasts) proliferation with a variable number and type of inflammatory cells. A case of intratracheal inflammatory pseudotumor in a 14-year-old boy is presented together with a review of all similar lesions in the available literature. The discussion includes the presentation of tracheal tumors, their basic morphologic and immunohistochemical characteristics, and treatment modalities that are available. The surgeon must exercise caution not to perform radical surgery based on the initial pathologic diagnosis from the intraoperative frozen section, because the prognosis of these benign lesions generally is excellent. This is the second reported case of intratracheal inflammatory pseudotumor successfully endoscopically vaporized using a CO2 laser, which is an excellent alternative in cases in which surgical treatment is feasible. J Pediatr Surg 36:631-634. Copyright © 2001 by W.B. Saunders Company.

Section snippets

Case report

A 14-year-old boy with an inconspicuous medical history (except for few episodes of subglottic laryngitis, 1 episode of pneumonia at age 4, and possible herpes zoster infection at 10 years of age) presented to the emergency room at a local hospital with acute respiratory distress. There was a history of a variable degree of breathlessness throughout the previous month attributed to acute pharyngitis and spastic bronchitis. He was admitted and treated with antibiotics, bronchodilatators,

Discussion

We have found 4 reports of tracheal inflammatory pseudotumors and 9 similar tracheal tumors with different names in the available literature (Table 1).3, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25

. Reviewed Tracheal Lesions

StudyAgeSymptomsLocalizationPathohistologyTreatment
Bahadori and Liebow,3 19731 yrHypoxia, deathTracheapcgNo therapy
Karlen et al,15 197357 yrWheezing, hemoptysis4 cm subglotticfhisbhsc
Hakimi et al,16 197526 yrCough, hemoptysisThoracic inletpcgsurg
Sandstrom et al,17 197815 yr

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    Address reprint requests to Z̆eljko Bumber MD, PhD, ENT Department, Clinical Hospital Center, S̆alata 4, 10000 Zagreb, Croatia.

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