Leiomyoma of the Trachea
LAURENCE K. GROVES, M.D.
Department of Thoracic Surgery
WILLIAM R. BIDDLESTONE, M.D.
Department of Pulmonary Disease
LAWRENCE J. McCORMACK, M.D.
Department of Pathology
TUMORS rarely occur in the trachea and most of those that do occur are malignant. We are reporting a case of an unusual benign neoplasm, a leiomyoma, of the trachea which we believe is the sixth such case to be recorded in the literature.
Moersch, Clagett, and Ellis1 in reviewing 82 cases of tracheal neopla-classified 35 as benign and 47 as malignant tumors. However, with the exceptio of one, a chondroma, the lesions that they classified as benign tumors often are considered not to be truly neoplastic: papilloma, tracheopathia osteoplastica, amyloid tumor, and xanthoma. Malignant tracheal tumors are most commonly either carcinomas indistinguishable from bronchogenic carcinomas, or “cylindromas.” It has been traditional to group carcinomas of cylindromatous pattern and adenomas of carcinoid structure under the term bronchial adenoma. We believe that this grouping is illogical because it infers that a “cylindroma” is a benign tumor. The carcinoid bronchial adenoma is a relatively benign lesion; however, by comparison, the cylindromatous carcinoma, which tends to occur more proximally in the respiratory tract, is definitely carcinomatous and usually lethal. Cylindromatous carcinoma in the respiratory tract is rare; no cases have been seen at the Cleveland Clinic since 1948, yet in these past 10 years carcinoid bronchial adenoma has been diagnosed in 21 patients.2
A few benign or malignant smooth-muscle tumors of the respiratory tract have been reported.3–5 We have found references to only five, all leiomyomas, occurring in the trachea. Dorenbusch6 reported one case in which a leiomyoma occurred a short distance. . .