Tracheal Chondrosarcoma Masquerading as COPD

We report the case of a tracheal chondrosarcoma with malignant infiltration of the thyroid gland, initially misdiagnosed as COPD.A 67-year-old female was referred with recent haemoptysis on a background of a several month history of increasing dyspnoea and wheeze. She remained otherwise well and denied any associated symptoms. Her past medical history included atrial fibrillation and she was an ex-smoker of less than 2-pack years having stopped over 50 years ago. In view of her symptoms, she was diagnosed with COPD in primary care and only referred in the wake of new haemoptysis. Clinical examination revealed a marked upper airway wheeze and was otherwise unremarkable.Spirometry revealed an FEV1 of 1.61 (82%), FVC 2.69 (114%) and ratio of 59% alongside flattening of the expiratory limb on flow volume loop. A chest radiograph was unremarkable however CT thorax demonstrated a 13x26mm anterior tracheal mass with infiltration into the thyroid gland. Histology following rigid bronchoscopy with debulking was consistent with a grade 1 chondrosarcoma. She underwent tracheal resection with primary anastomosis and a total thyroidectomy complicated by anastomotic leak, managed conservatively. She now remains well with no evidence of recurrence.Tracheal chondrosarcomas account for only 0.2% of all malignant tumours of the respiratory tract. Whilst the clinical presentation mimics many other common respiratory pathologies, our case highlights the crucial importance of carefully reviewing ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research