title: Application of interventional bronchoscopic therapy in eight pediatric patients with malignant airway tumors.
abstract: OBJECTIVE
  Malignant airway tumors in children have rarely been reported. We evaluated the safety and therapeutic effects of interventional bronchoscopic therapy in 8 children with malignant airway tumors.
  
  
  METHODS
  We retrospectively analyzed 8 children with malignant airway tumors diagnosed by pathology, and evaluated their clinical features, chest computer tomography findings and bronchoscopic manifestations.
  
  
  RESULTS
  Two of the 8 pediatric patients had high-grade malignancies (lymphoma and sarcoma) and the others all had low-grade malignancies, including 2 cases with mucoepidermoid carcinoma and 4 cases with inflammatory myofibroblastic tumor. Their ages ranged from 4 to 8 years (mean, 5.7 ± 0.9). There were no specific clinical manifestations in the children, and all of them presented with various respiratory symptoms, including cough and gasping associated with hemoptysis. Chest CT indicated round intra-airway neoplasms. Obstructive pulmonary atelectasis occurred in the main bronchus of 4 patients (3 cases of the left main bronchus and 1 case of the right intermedius bronchus). All children (1 case with local anesthesia and 7 cases with general anesthesia) underwent interventional bronchoscopic therapy, including argon plasma coagulation and CO 2 cryosurgery. The success rate for the rigid procedures was 100.0% (7/7), and the cure rate after 3 months was 85.7% (6/7). A part of the tumor remained in the lung of 1 patient with inflammatory myofibroblastic tumor after bronchoscopic treatment. One patient with local anesthesia died of suffocation caused by tumor consolidation during the bronchoscopic procedure. There were no recurrences in 6 patients during the follow-up period. One recurred patient was cured at 6 months.
  
  
  CONCLUSIONS
  There are no specific manifestations in children with malignant airway tumors. Interventional bronchoscopic therapy seems to be safe and effective for those tumors under general anesthesia.
authors.affiliation: Minimal Invasive Tumor Therapy Center, Beijing Coal General Hospital, Beijing, China. wanghongwu2008@yahoo.cn
authors.forename: Hongwu
authors.initials: H
authors.lastname: Wang
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Meimei
authors.initials: M
authors.lastname: Tao
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Zhou
authors.forename: Hang
authors.initials: H
authors.lastname: Zou
authors.forename: Sujuan
authors.initials: S
authors.lastname: Liang
authors.forename: Jing
authors.initials: J
authors.lastname: Li
mesh_terms: D000768:Anesthesia, General; D057908:Argon Plasma Coagulation; D001984:Bronchial Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods; D002245:Carbon Dioxide / Q000627:therapeutic use; D018277:Carcinoma, Mucoepidermoid / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D003452:Cryosurgery / Q000379:methods; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006469:Hemoptysis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000601:surgery; D008297:Male; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide