Diagnosis of Tracheal Tumors

Tumors of the trachea are rare. Unfortunately, the inclusion of tracheal tumors in the differential diagnosis of adult onset wheezing is even more rare. Twenty-one cases seen at the Columbia-Presbyterian Medical Center are reviewed. The average delay in diagnosis from the patient's first doctor visit was ten months. Major symptoms, related to airway obstruction, include wheezing, cough, shortness of breath and hemoptysis. Pain, dysphonia and weight loss were associated exclusively with malignancies. Routine x-rays and physical examinations do not elucidate the pathology. Eleven of twenty chest x-rays were reported negative. Special x-ray studies described were positive in every case ordered despite negative chest survey. Endoscopy is necessary for the definitive diagnosis. A program to limit the physician delay is proposed. Individual case reports are used to illustrate these points. They include a case of sclerosing hemangioma type of fibrous histiocytoma and one of neurilemmoma, both reported for the fi...