Unexpected cause of dyspnea: A case of pleomorphic adenoma in the trachea

Abstract

Pleomorphic adenoma (PA) is the most common benign histological form of salivary gland tumors, particularly in the parotid gland, primarily affecting women between the ages of 40 and 60. However, its occurrence in the trachea is very rare. This article reports the case of a 48-year-old woman presenting with progressive dyspnea and weight loss, initially suspected of having a pulmonary embolism. A chest CT scan revealed a nearly circumferential tracheal lesion with 2 nodules partially obstructing the tracheal lumen. Histological analysis confirmed the presence of a pleomorphic adenoma of the "salivary gland" type. Although rare, tracheal pleomorphic adenoma should be considered in the differential diagnosis of tracheal tumors. MRI is the preferred examination for detecting tumors in the parotid gland region, offering excellent tissue differentiation. Surgery remains the treatment of choice to prevent recurrence.

Keywords: CT scan; Pleomorphic adenoma; trachea.

Fig. 1

Thoracic CT angiography in mediastinal window in axial (A), coronal (B), and sagittal (C) views showing a right paratracheal process () with 2 intratracheal buds () reducing the lumen.

Fig. 2

Microscopic examination showing a benign tumor proliferation composed of epithelial cells arranged in sheets or tubular structures, within a myxoid background, without architectural disorganization, nuclear atypia, or mitoses. (Hematoxylin and eosin staining, original magnification x200).