Radiotherapy in the Treatment of Unresectable Recurrent Tracheal Pleomorphic Adenoma: A Case Report and Review of the Literature

Pleomorphic adenoma of the trachea is a rare tumor, with fewer than 50 cases reported. Its nonspecific symptoms can delay diagnosis. We describe the case of a 48-year-old woman with recurrent obstructive pleomorphic adenoma of the trachea. She was initially treated with endoscopic resection in 2019. In 2024, she developed increasing respiratory distress due to an inoperable recurrence. The patient received volumetric modulated arc therapy (VMAT) with a dose of 20 Gy in five treatments of 4 Gy each. This provided rapid symptom relief, and significant regression was observed on radiological imaging at three and 12 months. Although complete surgical removal remains the best option, this case shows that radiation therapy can be an effective choice for inoperable or recurrent tumors. The positive clinical and radiological results we observed underscore the role of radiotherapy in achieving durable local control and symptom relief. This highlights the need for thorough evaluation by multiple specialists and long-term follow-up.