Tracheal Tumors Flashcards
Most tracheal tumors are benign or malignant?
Malignant
(MC SCC and adenoid cyststic carcinoma)
MC primary malignant tracheal tumors
- SCC
- Adenoid cystic carcinoma
- Less common tumors:
- Carcioids
- Bronchogenic carcinoma
- Sarcoma
Demographics of SCC and adenoid cystic carcinoma of trachea
- MC in men (both)
- MC in smokers (both)
- Adenoid cystic: earlier in life (40-50 years old)
- SCC: older in life (60-70 years old)
SCC or Adenoid Cystic Carcinoma:
Invades LN and mediastinum
SCC
(Adenoid cystic metastasizes vis submucosa; less likely to spread to LN)
SCC or Adenoid Cystic Carcinoma:
Mestastasize vai submucoa
Adenoid cystic carcinoma
(SCC via LN)
MC tumors to metastasize to trachea
- Laryngeal ca
- Lung ca
- Thyroid ca
- Esophageal ca
MC presenting s/s of tracheal tumors
Slowly progressive obstructive respiratory sx (wheezing or stridor)
(often misdiagnosed as adult-onset asthma)
Diagnostic modalities utilized for tracheal tumors
- CT
- Bronchoscopy
- Rigid bronchoscopy (ID tumor location and external compression, biopsy)
Important principle for biopsies of tracheal tumor
Biopsy proximal and distal to visualized tumor
(accurately map tumor tumor size and involvement)
During dissection of the trachea, how much of the trachea can be delivered into the neck with hyperextension
50% of the length
Location of the blood supply to the trachea
Lateral borders
(fusion of inferior thyroid, bronchial, and internal thoracic arteries)
Location of Right and Left recurrent laryngeal nerve in relation to trachea
- Right: along upper to mid trachea
- Left: along majority of the entire length of trachea
Indicatins for tracheal resection and reconstruction for tracheal tumors
- Lack of metastatic disease
- Ability to determine resectibility
Resectibility of tracheal tumors depends upon which factors:
- Length of trachea required for resection
- Extent of invasion into adjacent strucutres
- Patients functional status
Maximum amount of trachea that is usually amenable to reconstruction
Up to 6 cm