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Clinical Problem Solving: Pathology
August 17, 2009

Pathology Quiz Case 2

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2009;135(8):833. doi:10.1001/archoto.2009.83-a

A 42-year-old man presented to a community medical center with progressive dyspnea and cough. Flexible fiberoptic laryngoscopy demonstrated the presence of a subglottic mass. Magnetic resonance imaging revealed a tracheal mass between the first and second tracheal ring. The patient was taken to the operating room for a direct laryngoscopy and biopsy. During the surgery, a polypoid, firm mass was observed originating from the posterior tracheal wall at the level of the first and second tracheal rings. There was substantial bleeding after the biopsy. An immediate midline tracheotomy was then performed, followed by resection of the tumor via a cricoid split approach. Postoperative recovery was uneventful, and the patient underwent decannulation before discharge. There was still no recurrence 1 year after the procedure.