PMC5415294_01
Thoracic radiographs at initial presentation (day 1) showing an irregularly narrowed tracheal lumen from the level of vertebra C7 through T4. There was soft tissue opacity overlying the dorsal trachea from the first rib to the second rib and a curvilinear irregularly margined soft tissue opacity on the ventral aspect of the trachea extending from the second rib to the fourth rib
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T4. There was soft tissue opacity overlying the dorsal trachea from the first rib to the second rib and a curvilinear irregularly margined soft tissue opacity on the ventral aspect of the trachea extending from the second rib to the fourth rib (Figure 1).
CT scan at initial presentation (day 2) showing narrowing of the trachea due to a soft tissue mass in the dorsal aspect of the lumen and flattening of the ventral aspect of the canal on the right side
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CT scan and with intermittent propofol (1.2 mg/kg IV) boluses during bronchoscopy and esophagoscopy. CT of the cervical and thoracic trachea confirmed narrowing of the trachea at C6 through T1 due to a soft tissue mass in the dorsal aspect of the lumen and flattening of the ventral aspect of the canal on the right side (Figure 2).
Bronchoscopy image (day 2) showing an irregular and multilobulated intraluminal tracheal mass
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The mass was present on the dorsal and ventral aspects of the tracheal lumen, appearing to be partially circumferential (Figure 3).
Thoracic radiographs following definitive radiation therapy (day 81) showing radiographic improvement of intraluminal tracheal mass
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The first recheck thoracic radiograph was performed 45 days following completion of RT (day 81), which revealed partial remission of the tracheal adenocarcinoma and no evidence of pulmonary metastatic disease (Figure 4).
Second bronchoscopic examination performed after definitive radiation therapy (day 383) for work-up of insidious coughing showed several multifocal, raised, nodular lesions noted throughout the trachea
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Abnormal findings included several multifocal, raised, nodular lesions noted throughout the trachea with the most affected area being the beginning of the intrathoracic trachea (Figure 5).
Recheck CT exam 16 months after definitive radiation therapy (day 525), which revealed distortion of the trachea secondarily to an intraluminal tracheal mass
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The distortion was marked from C5 to T1 secondarily to the presence of a contrast-enhancing intraluminal mass that covered the inner aspect of the trachea (Figure 6). There was no evidence of local or regional lymphadenomegaly.
Recheck CT following palliative radiation therapy (day 567). Findings were consistent with a partial response to radiation
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Findings were consistent with a partial response to RT (Figure 7).
Recheck thoracic radiographs performed on day 607 showing progression of disease with a slight increase in length of the tracheal mass
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Recheck thoracic radiographs performed on day 607 revealed progression of disease with a slight increase in length of the tracheal mass when compared with the previous radiographs (Figure 8).