Figure 1. Computed Tomography A) Axial view with 1) intraluminal polypoidal mass 2) extraluminal component of the mass B) Mediastinal Window showing the intraluminal mass occluding 75% of the tracheal lumen C) Sagittal view
Not sure of the origin, either from the thyroid or trachea, an ultrasound neck along with FNAC of the lesion in the neck was performed as it was least invasive with better yield. FNAC revealed it to be Spindle Cell tumor likely a Schwannoma. To better delineate the lesion and as workup for tumor, whole body MRI was performed as PET-CT was not available. MRI was suggestive of single lesion with involvement of thyroid and infiltration into the trachea causing marked obstruction. No lymph nodes were noted in the neck.
With the intent of relieving the airway, biopsy of the tracheal tumor and assessment of the tumor as well as distal bronchial tree, rigid and flexible bronchoscopy with Nd:YAG laser ablation of tumor was performed. Tumor was sessile of size 2*1.5cm in the left posterolateral aspect of the trachea about 2cm below the True Vocal Cords almost occluding 75% of the tracheal lumen(Figure2).