Tracheal Tumors – Signs, Triggers, and Therapeutic Options

A thorough understanding of tracheal tumors is essential in the field of respiratory diseases. The trachea, which extends from the lower part of the larynx to the main bronchi, plays a crucial role in breathing. The length of the trachea varies from person to person, but it generally ranges from 10 to 16 centimeters. The right main bronchus is a direct continuation of the trachea, while the left forms an arc to make room for the heart and larger vessels.

Structure of the Trachea

The structure of the trachea consists of various tissues, with cartilage and connective tissue being predominant. The posterior part of the trachea is softer, allowing different lesions to spread more easily in this zone. Ciliated columnar epithelial cells are responsible for clearing the airways, but if these cells are exposed to harmful substances for an extended period, their function may deteriorate. The incidence of tracheal tumors is relatively low; however, early diagnosis and treatment are crucial for patients.

Appearance and Frequency of Tracheal Tumors

The occurrence of tracheal tumors accounts for only 0.1-0.4% of all cancer cases. This means that approximately one case occurs per million people each year. Tracheal squamous cell carcinoma is more frequently diagnosed in men, typically identified between the ages of 60 and 70. According to statistics from the past decades, the incidence of tracheal tumors in Hungary was around 30 cases for men and below 10 for women.

Risk Factors for Tracheal Tumors

Risk factors for tracheal tumors include smoking and the inhalation of various carcinogenic substances. Due to the soft tissues that make up the posterior part of the trachea, malignant lesions can easily take hold, often originating from lymph nodes or other adjacent areas. Therefore, the identification of tracheal tumors depends not only on the condition of the trachea itself but also on the state of surrounding tissues and organs.

Symptoms of Tracheal Tumors

Symptoms of tracheal tumors often present late, as tracheal narrowing only causes complaints when the tumor significantly occupies the tracheal diameter. The most common signs of the disease include shortness of breath, wheezing, and coughing. In cases of bloody sputum, determining the source of the bleeding is crucial, as it may be linked to various respiratory areas. Additionally, difficulty swallowing, fever, chest or abdominal pain, and frequent infections may also indicate the presence of a tracheal tumor.

Early-stage complaints, such as sudden-onset coughing, may suggest squamous cell carcinoma, while slowly progressive symptoms are more characteristic of other lesions, such as cystic adenoma. It is important to note that symptoms of tracheal tumors are not specific, which can delay diagnosis, especially if the patient has other respiratory diseases, such as COPD or asthma.

Diagnosis and Treatment of Tracheal Tumors

The most important tool for diagnosing tracheal tumors is endoscopic examination, which also allows for histological sampling. Endoscopy is often combined with ultrasound to assess the condition of the bronchial wall. Additionally, fluorodeoxyglucose positron emission tomography (FDG-PET-CT) can aid in evaluating tumor spread. Further tests may be necessary to assess the patient’s overall condition.

Treatment of tracheal tumors typically requires surgical intervention aimed at removing the tumor. If the tumor is small, removing the tracheal mucosa may be sufficient; however, surrounding lymph nodes must also be removed to prevent disease progression. Radiation therapy, such as brachytherapy, may also be applicable, especially in cases of tracheal stenosis.

Medication-based tumor-suppressing treatment, including the use of chemotherapy agents, may also play a role, particularly if the disease is in an advanced stage. Immunotherapy offers new possibilities for patients, enabling personalized treatments based on molecular genetic testing. Therefore, the treatment of tracheal tumors is complex, with early diagnosis and appropriate therapy being essential for the best prognosis.