TRACHEAL NEOPLASMS IN CHILDREN

Primary tracheal neoplasms are extremely rare lesions in the pediatric age group. This study reviews the English-language literature to bett er characterize these lesions in children and reports 2 additional pat ients. Reports of only 36 infants and children through adolescence wit h primary tracheal neoplasms were discovered after an exhaustive liter ature review of the last 30 years. The data are analyzed with regard t o pathology, demographics, symptomatology, site, and percent luminal o bstruction. We report 2 additional patients with photographic document ation, imaging studies, and histopathology. Of the 36 previously repor ted lesions, 64% were characterized as benign and 36% as malignant. Fi fty-six percent of all lesions were initially misdiagnosed as asthma. The most common site was the posterior membranous wall of the cervical trachea. In 14 (39%) of the 36 patients, the lesions obstructed more than 50% of the lumen at the time of diagnosis. The timely diagnosis o f tracheal masses depends upon maintaining a high index of suspicion a nd conducting an efficient workup, including definitive evaluation by bronchoscopy. The evaluation and the differential diagnosis of trachea l neoplasms in the pediatric population is discussed.