Asthma Symptoms Mimicking Myofibroblastic Tracheal Tumor in Pediatric Diagnosis

Tracheal tumors in pediatric patients are rare, accounting for 2% of all airway abnormalities and 0.2% of all pediatric tumors. Diagnosis is often delayed due to the heterogeneity of presenting symptoms, such as stridor and wheezing, which are frequently misattributed to other conditions. We report the case of a previously healthy nine-year-old male who was diagnosed with an inflammatory myofibroblastic tumor (IMT) following five months of persistent airway symptoms, including cough, biphasic stridor, wheezing, and dyspnea. Despite evaluation by multiple physicians and treatment for presumed asthma, his symptoms did not fully resolve. Imaging studies ultimately confirmed the diagnosis, and surgical resection of the tracheal tumor was performed. In the late postoperative period (12 weeks), the patient continued to experience cough and dyspnea. Given a family history of asthma (father with asthma), spirometry with a bronchodilator was conducted, confirming a diagnosis of asthma alongside IMT. The patient is currently alive and undergoing treatment in Step 2 of the Global Initiative for Asthma (GINA) guidelines. This case highlights the importance of a thorough evaluation in children with persistent stridor and wheezing to rule out underlying tracheobronchial pathologies.