Pleomorphic carcinoma of the trachea after chemoradiotherapy for laryngeal cancer

A 66-year-old male patient who had received chemoradiotherapy (CRT) for laryngeal cancer 2 years ago visited a local doctor complaining of dyspnoea and wheezing. CT scan showed narrowing of the trachea caused by a tumour. We intubated the trachea over the tumour using a bronchoscope. A week later, t...

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Bibliographic Details
Published in:BMJ case reports 2020-10, Vol.13 (10), p.e236819
Main Authors: Saikawa, Hirotaka, Uesugi, Noriyuki, Sugai, Tamotsu, Maemondo, Makoto
Format: Article
Language:English
Subjects:
Antibiotics
Asthma
Blood tests
Bronchoscopy
Cancer therapies
Cartilage
Case reports
Cell growth
Chemoradiotherapy
Chemotherapy
Diagnosis, Differential
Dyspnea
Head & neck cancer
Humans
Laryngeal cancer
Laryngeal Neoplasms - diagnosis
Laryngeal Neoplasms - therapy
Laryngoscopy - methods
Male
Medical imaging
Medical prognosis
Metastasis
Middle Aged
Neoplasms, Second Primary - diagnosis
Neoplasms, Second Primary - therapy
Ostomy
palliative care
pathology
Radiation therapy
Rare Disease
respiratory cancer
smoking and tobacco
Trachea - pathology
Tracheal Neoplasms - diagnosis
Tracheal Neoplasms - therapy
Tumors
Ventilators
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Summary:A 66-year-old male patient who had received chemoradiotherapy (CRT) for laryngeal cancer 2 years ago visited a local doctor complaining of dyspnoea and wheezing. CT scan showed narrowing of the trachea caused by a tumour. We intubated the trachea over the tumour using a bronchoscope. A week later, the truncated tracheal tumour obstructed the tracheal tube, compromising the patient’s breathing. We removed the obstructed tube and inserted a new one. We submitted the tissue from the tube to a pathologist. Histopathological diagnosis was pleomorphic carcinoma, a subtype of sarcomatoid carcinoma. The mechanism of epithelial–mesenchymal transition (EMT) occurring after CRT was detected in the tumour. Because he had undergone CRT for laryngeal cancer, surgery was not indicated, and we started radiation therapy. Sarcomatoid carcinomas including pleomorphic carcinoma of the trachea are extremely rare, with few reported cases, and EMT is associated with this histological type and CRT.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-236819