title: Successful surgical resection of leiomyoma obstructing the trachea.
abstract: We report a case of 51-year-old woman with a severely airway-obstructing leiomyoma who underwent successful tracheal resection. A preoperative tumor biopsy was avoided not to cause any risk of suffocation. At surgery, an endotracheal intubation distal to the tumor was achieved with a bronchoscopic guidance. A segmental resection of the trachea with a primary end-to-end anastomosis was performed via a half-splitting median sternotomy. Negative surgical margins for tumor were confirmed intraoperatively. Final pathological diagnosis was a primary tracheal leiomyoma. Definitive surgical resection is a treatment of choice for such airway-obstructing, wide-based leiomyoma. Although a bronchoscopic removal of the tumor is an alternative choice, the risks of suffocation, positive surgical margins, and perforation of the trachea need to be carefully discussed if it is considered.
authors.affiliation: Division of General Thoracic Surgery, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan. kaseda@wb4.so-net.ne.jp
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kaseda
authors.forename: Masaki
authors.initials: M
authors.lastname: Anraku
authors.forename: Taichiro
authors.initials: T
authors.lastname: Goto
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Mitsutomo
authors.initials: M
authors.lastname: Kohno
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Izumi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
mesh_terms: D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014134:Tracheal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*