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A tracheal tumor is an abnormal growth that forms in your trachea, or windpipe.
Your trachea carries the air you breathe down into your lungs. It starts just below the level of your larynx (voice box) and ends in your chest, where your airway divides into the two branches called bronchi, which go to your lungs.
In an adult, the trachea is about five inches long and about one inch wide. Tracheal tumors can be benign (noncancerous) or malignant (cancerous). In adults, most tracheal tumors are malignant. In children, most tracheal tumors are benign.
Tumors that begin to grow in the trachea are quite rare. You are at increased risk for the most common type of malignant tracheal tumor if you are or have been a smoker. Men are up to four times more likely to have a malignant tracheal tumor and they are usually between 60 and 70 years old when it happens.
Tracheal tumors that start in the trachea are called primary tracheal tumors. Tumors that start in another part of your body and spread to the trachea are called secondary tracheal tumors, and they are rare. Most of these secondary tumors spread to your trachea from your thyroid gland, lungs, or esophagus.
These are the two types of primary tracheal tumors:
Squamous cell cancer. This is the most common type of tracheal tumor. It is almost always associated with cigarette smoking. This tumor grows quickly, and almost half the time it is already too big to be removed when it is discovered.
Adenoid cystic carcinoma. This tracheal tumor grows much more slowly than squamous cell cancer. It is not related to smoking, and men and women have the same risk. It can develop at any age, but it is most common around age 40.
These are common types of noncancerous tracheal tumors:
Papillomas. Squamous cell papilloma is a benign type of tracheal tumor seen in adults who smoke. Children may get a type of papilloma called juvenile laryngotracheal papillomatosis that’s caused by a virus.
Chondroma. This is the most common type of benign tracheal tumor. It forms from the cartilage that makes up the structure of the trachea. This type of tumor can change into a malignant tumor over time.
Hemangioma. This type of tracheal tumor forms from tiny blood vessels. It can affect both children and adults. It may be diagnosed in children who have sudden breathing problems and also have a hemangioma birthmark on their skin.
Symptoms of tracheal tumors may be confused with other, more common breathing conditions such as asthma, bronchitis, or chronic obstructive pulmonary disease. Symptoms may include:
Stridor (noisy breathing)
Shortness of breath
Frequent upper airway infections
Coughing up blood
Diagnosing a tracheal tumor begins with a history and physical exam. Your caregiver will ask you questions about your symptoms and listen to your breathing. The best way to diagnose a tracheal tumor is for your doctor to look directly into your trachea with a lighted scope and to take a piece of the tumor so that it can be looked at under a microscope.
The procedure for looking at your trachea is called bronchoscopy. It can be done with a flexible or a firm scope. Taking a piece of tumor for diagnosis is called a biopsy. Here are some other tests that can help with diagnosis:
Chest X-ray; this is used to show a tracheal tumor in about half the cases
CT scan of your chest and trachea
Respiratory function tests, to show how much the tracheal tumor is affecting your breathing
The type of treatment used for a tracheal tumor will depend on its type and size, as well as your age and health. In general, surgical removal is the best treatment for both benign and malignant tracheal tumors that are less than half the size of the trachea.
Here are details about some of the possible treatments:
Surgery. Up to half of the trachea can be removed and safely reconstructed. Tumors in the upper part of the trachea are removed through a neck incision. Tumors lower down in the trachea may require a procedure that goes through the chest.
Radiation therapy. This treatment may be used to treat tumors that are more than half the size of the trachea or that have spread outside the trachea.
Chemotherapy. This may be combined with radiation therapy for large tumors that cannot be removed by surgery.
Bronchoscopic treatments. For tumors that cannot be removed by surgery, a surgeon may be able to work through a bronchoscope to reduce the size of the tumor. In some cases, reducing the size may make surgical removal possible.
Stenting. In cases where a tumor cannot be removed, the airway may be kept open by placing a manmade tube through the trachea. This breathing tube is called a tracheobronchial airway stent.
The most common type of tracheal tumor in adults is squamous cell cancer. Squamous cell tracheal tumors are almost always associated with cigarette smoking. The best way to prevent this type of cancer is to quit smoking or not to start.
Managing a tracheal tumor depends on what type of tumor you have and what type of treatment you receive. Learning as much as you can about your disease, taking an active role in your treatment, and working closely with your medical team are important steps to manage a tracheal tumor.
Many people with a serious disease like this also benefit from the social and educational support they receive from a support group.
Ask your medical team if there are any dietary supplements you should try. Relaxation techniques such as exercise, meditation, or a mind-body activity like yoga help many people deal with the stress of a serious medical condition.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.