Aydın YILMAZ, Havva YEŞİLDAĞLI, Zafer AKTAŞ, Ayperi ÖZTÜRK, Leyla MEMİŞ

Astım tanısı alan trakeal leiyomiyom olgusu

Trakeanın primer tümörleri genellikle maligndir; benign tümörleri ise nadir görülür. Trakeal leiyomiyomlar alt solunum yolu benign tümörlerinin %1'ini oluşturur. Astım tanısıyla bir yıldır takip edilen 25 yaşında kadın hastanın düzenli inhaler tedaviye rağmen dispnesinin gerilememesi nedeniyle çekilen akciğer grafisinde orta zonda opasite izlendi. Bilgisayarlı tomografisinde trakea proksimalinde posterior duvardan lümene uzanan, hava sütununu tama yakın daraltan lezyon saptandı. Lezyonun kanama riski gözönünde bulundurularak genel anestezi altında rijid bronkoskopi yapıldı ve trakeayı tama yakın tıkayan solunumla hareketli endobronşiyal lezyon çıkarıldı; lezyon tabanına kriyoterapi uygulandı. Histopatolojik olarak leiyomiyom tanısı alan hasta takibinin 12. ayındadır.

A case of tracheal leiomyoma misdiagnosed as asthma

Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum. In computed tomography, a lesion has been detected in proximal trachea, arising from the posterior wall and protruding through the lumen and almost obliterating the air column. Rigid bronchoscopy has been performed under general anesthesia due to a high risk of bleeding and the endobronchial lesion, freely moving with respiration, has been removed and cryotherapy was applied to the base of the lesion. Receiving the histopathological diagnosis of leiomyoma, the patient is now on 12th month of the follow-up without any recurrence.

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