Case Report
Dyspnea After Tracheostomy for Painful Cervical Swelling: What is Your Diagnosis?
Rachidi Alaoui Siham1,2, Rkain ilham1,3*, Touihmi Safaa3 and Motiaa Youssef1,4
1Faculty of Medicine and pharmacy of tangier, Abdelmalek Saadi University, Tétouan, Morocco
2Department of radiology, university hospital, Tanger, Morocco
3Department of otorhinolaryngology, Head and Neck surgery, university hospital, Tanger, Morocco
4Department of anesthesiology and intensive care, university hospital, Tanger, Morocco
Rkain Ilham, Department of otorhinolaryngology, Head and Neck Surgery, university hospital, Tangier, Faculty of Medicine and pharmacy of tangier, Abdelmalek Saadi University, Tétouan, Morocco.
Received Date: August 05, 2020; Published Date: September 01, 2020
Case Report
![Click here to view Large Figure 1 irispublishers-openaccess-textile-science-fashion](../images/irispublishers-openaccess-otolaryngology-rhinology.ID.000560.G001.png)
![Click here to view Large Figure 2 irispublishers-openaccess-textile-science-fashion](../images/irispublishers-openaccess-otolaryngology-rhinology.ID.000560.G002.png)
A 60-year-old women was irradiated for oesophageal carcinoma one year ago. The patient has a cervical mass for 3 months, gradually increasing in volume, associated with high dysphagia and intermittent dysphonia. One month later, the symptoms were aggravated by the installation of an inspiratory dyspnea that became both inspiratory and expiratory. Physical examination finds a 10cm hard fixed and painful anterior cervical swelling ascending to swallowing, Nasofibroscopy finds a cordial diplegia in closure without individualization of tumor process. At the end of these symptoms, the patient had a cervico-thoracic CT scan. An emergency tracheostomy with surgical biopsy was performed in another hospital structure. The patient was lost to follow-up for two months, then she presented to the emergency room for dyspnea, hence the realization of a second cervico-thoracic CT scan (Figure 1,2).
Discussion
Anterior tracheal rupture is rare or even exceptional. It can be post-traumatic or due to tumor invasion. Surgical treatment and primary reconstructive method for tracheal defect from invasion by differentiated thyroid carcinoma was reported by Atsumori, Liu H, Lifante, et al. [1-3]. In the case of our patient, biopsy with anatomopathological examination revealed an indifferenciated thyroid carcinoma type anaplastic, hence the aggressiveness of the invasion of the anterior wall of the trachea (due to a weakening and lysis of the wall). Some authors have also reported the effect of radiotherapy on the occurrence of tracheal fistula during cancers of the cervical esophagus, by necrosis of the posterior wall of the trachea [4].
Acknowledgement
None.
Conflict of Interest
No conflict of interest.
References
- Atsumori Hamahata, Takeshi Beppu, Takashi Yamaki, Hiroyuki Sakurai (2018) Primary reconstructive method for tracheal defect from invasion by differentiated thyroid carcinoma. Auris Nasus Larynx 45(2): 371-376.
- Liu H, Li Z, Dong H, Leng H, Sun H, et al. (2014) Surgical treatment and reconstruction of thyroid carcinoma invading cervical esophagus and trachea full-thickness 28(24):1927-1930.
- Lifante JC, Mancini F, Mithieux F, Berger N, Latreche A, et al. (2001) Results of tracheal or esophageal resections in invasive thyroid carcinomas. Ann Chir 126(3): 236-241.
- Jose M Soliz, Dam Thuy Truong, January Y Tsai, Angela T Truong (2018) Images in Anesthesiology: Tracheopharyngeal Fistula from Treated Hypopharyngeal Carcinoma. Anesthesiology 128(2): 386.
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Rachidi Alaoui Siham, Rkain ilham. Dyspnea After Tracheostomy for Painful Cervical Swelling: What is Your Diagnosis?. On J Otolaryngol & Rhinol. 3(2): 2020. OJOR.MS.ID.000560.
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Nasofibroscopy, Oesophageal, Tumor invasion, Swallowing, Thoracic CT scan, Thyroid carcinoma, Anaplastic, Radiotherapy, Cervical esophagus.
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