Multidisciplinary management of tracheal paraganglioma with angiographic embolization and surgical excision: A case report and review of literature

采用血管造影栓塞和手术切除进行气管副神经节瘤的多学科治疗:病例报告及文献复习

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Abstract

RATIONALE: Tracheal paragangliomas (PGs) are exceedingly rare tumors originating from chromaffin cells. They often present with nonspecific symptoms like dyspnea and hemoptysis, which can mimic more common respiratory conditions such as asthma. PATIENT CONCERNS: We present the case of a 58-year-old female initially diagnosed with asthma who later experienced recurrent hemoptysis and worsening dyspnea. DIAGNOSES: Rigid bronchoscopy revealed a vegetative mass located 2 cm below the vocal cords, and a biopsy confirmed PG. Cross-sectional imaging identified a lobulated lesion on the posterior tracheal wall. INTERVENTIONS: To prevent excessive bleeding, angiographic embolization was performed before bronchoscopic surgical resection, involving super-selective catheterization of the tumor's arterial feeder. OUTCOMES: The embolization successfully reduced vascularity, facilitating safe tumor resection. The patient remains symptom-free at the 1-year follow-up, indicating effective management of the condition. LESSONS: This case highlights the importance of a multidisciplinary approach in diagnosing and treating tracheal PGs. Preoperative embolization is crucial for managing bleeding risks associated with these highly vascular tumors. Detailed insights into the angiographic procedure are provided, along with a systematic review of similar cases.

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