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Case Reports: Rare disease
Spindle cell sarcomatoid tumour of the trachea: a rare primary malignant tumour
  1. Emily Moore1,
  2. Shivun Khosla1,
  3. Sanjay Jogai2 and
  4. Stephen Derbyshire1
  1. 1ENT, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  2. 2Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Emily Moore; emily.moore18{at}nhs.net

Abstract

Spindle cell carcinoma is a subtype of sarcomatoid carcinoma, which has previously been described in various anatomical locations, though rarely in the trachea.

We present the case of a woman in her 70s who presented with a sore throat and stridor. Fibreoptic nasendoscopy demonstrated a tracheal mass occupying 80% of the airway from the cricoid cartilage to the third tracheal ring, infiltrating the thyroid gland. Subsequent CT demonstrated pulmonary emboli and vertebral metastasis. Biopsy of the infiltrated thyroid confirmed the diagnosis of spindle cell carcinoma. The length of the tumour and metastasis at presentation made this surgically unresectable, and she was referred for a palliative stent but died after an acute deterioration.

This pathology has been reported only five times previously in the literature, with management strategies varying greatly between patients. Primary tracheal tumours are difficult to manage as, due to their rarity, there are no clear guidelines.

  • Ear, nose and throat/otolaryngology
  • Head and neck surgery

http://dx.doi.org/10.1136/bcr-2022-252310

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    Footnotes

    • Contributors EM was the lead author for this case report, actively involved in patient care, and leading the writing of the manuscript. SK was the senior registrar actively involved in patient care and contributed to the manuscript. SJ was the histopathologist who provided the diagnosis and contributed to the manuscript. SD was the consultant in charge of the case, actively involved in patient decision making, and contributed to the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.