We report the case of a 24-year-old patient with a finding of a tracheal mass, seen in the respiratory medicine department for a study of probable asthma. He had been diagnosed with neurofibromatosis type 1 in childhood.
During the exploration of a 12-month history of progressive dyspnea, an alteration was observed in the image of the trachea on chest X-ray, and flattening of the F/V curves was detected. Bronchoscopy revealed a tracheal sessile mass, 5cm from the vocal cords, with 90% blockage of the lumen.
The tracheal tumor was removed under general anesthesia and rigid bronchoscopy using mechanical resection and Nd-YAG laser coagulation (Image 1A).
(A) Image of the endotracheal tumor via the rigid bronchoscope, with the Nd:YAG laser fiber and aspiration probe. (B) Proliferation of spindle cells, cigar-shaped nuclei, and elongated cytoplasms, below the bronchial epithelium, H–E ×20. (C) S100 positivity for in these cells, ×40.
The pathological study revealed myxoid tissue with spindle cells, cigar-shaped nuclei, and elongated cytoplasms. The immunohistochemical study showed an abundant presence of S100 protein. The diagnosis was endotracheal neurofibroma (Image 1 B and C).
The patient remains asymptomatic and free of recurrence 14 months after the intervention.
The bronchoscopic treatment of neurogenic tumors was first reported in 1983.1 Endoscopic treatment without surgery can be considered definitive in benign polypoid tumors with a lesion base of less than 15mm2 and a strictly intraluminal component, since the risk of recurrence is extremely low.2
Please cite this article as: Cilleruelo Ramos A, Borrego Pintado H, Castanedo Allende M. Tratamiento endoscópico de neurofibroma traqueal. Arch Bronconeumol. 2020;56:116.
