Tracheal Pleomorphic Adenoma With Severe Airway Obstruction

Pleomorphic adenoma of the trachea is a rare benign tumor, often challenging to diagnose due to nonspecific symptoms. We report a case of a 72-year-old female with a 10-year history of presumed bronchial asthma, presenting with persistent dyspnea. Preoperative assessment for breast cancer surgery revealed severe obstructive ventilatory impairment. Further investigation with chest CT and bronchoscopy identified an intratracheal nodule, which was successfully resected using electrocautery and cryotherapy via rigid bronchoscopy. Pathological examination confirmed pleomorphic adenoma. Following the intervention, the patient's lung function significantly improved, enabling the planned breast cancer surgery. This case highlights the importance of considering rare tracheal tumors in the differential diagnosis of refractory respiratory symptoms. A review of 11 cases of tracheal pleomorphic adenomas managed by bronchial intervention showed various endoscopic resection techniques, with electrosurgical snaring and argon plasma coagulation being the most common. Our case illustrates the effectiveness of bronchial intervention in managing tracheal tumors with severe airway obstruction and emphasizes the need for thorough preoperative assessment and heightened suspicion for rare tracheal tumors in persistent, treatment-resistant respiratory symptoms.