Chondrosarcoma of trachea: case report of successful surgical treatment of local recurrence

The study objective is to report a case of tracheal chondrosarcoma, which is a very rare malignant tumor. Only 18 cases have been described so far in English medical literature.

Materials and methods. A 74-year-old male patient visited an otorhinolaryngologist in August 2011 with complaints of hoarseness of voice, which have been gradually increasing during the last 3 years. The patient was diagnosed with myxoid chondrosarcoma.

Results. In September 2011, the patient underwent thyroidectomy and circular resection of the trachea at the level of its second ring with the creation of a tracheal anastomosis. This volume of surgery was determined by the presence a thyroid nodule in the right thyroid lobe, which invaded the cricoid cartilage and the first ring of the trachea. In November-December 2011, the patient underwent a course of adjuvant external beam radiotherapy with a total dose of 50 Gy delivered in 2.0 Gy fractions, 5 days per week. No cancer recurrence had been observed during 3 years and 9 months of follow up. In September 2015, the patients was found to have a 24-mm thyroid nodule with an exophytic component in the right thyroid cartilage plate. This finding was considered as recurrent chondrosarcoma. In May 2016, the patient had laryngectomy. We performed margin-negative (R0) resection. The patient has now been in remission for 2 years and 9 months.

Conclusion. We demonstrate successful treatment of a patient with tracheal chondrosarcoma with a long-term remission after surgery for recurrent tumor.

1. Daniels A.C., Conner G.H., Straus F.H. Primary chondrosarcoma of the tracheobronchial tree. Report of a unique case and brief review. Arch Pathol 1967;84(6):615—24.

2. Fallahnejad M., Harrell D., Tucker J. et al. Chondrosarcoma of the trachea. Report of a case and five-year follow-up. J Thorac Cardiovasc Surg 1973;65(2):210—3.

3. Weber A.L., Shortsleeve M., Goodman M. et al. Cartilaginous tumors of the larynx and trachea. Radiol Clin North Am 1978;16(2):261—71.

4. Slasky B.S., Hardesty R.L., Wilson S. Tracheal chondrosarcoma with an overview of other tumors of the trachea. J Comput Tomogr 1985;9(3):225—31. DOI: 10.1016/0149-936X(85)90066-9.

5. Arevalo M., Ordi J., Renedo G. et al. Chondrosarcoma of the trachea: report of a case. Respiration 1986;49(2):147—51. DOI: 10.1159/000194872.

6. Matsuo T., Kinoshita S., Iwasaki K. et al. Chondrosarcoma of the trachea: a case report and literature review. Acta Cytol 1988;32(6):908—12.

7. Salminen U.-S., Halttunen P., Taskinen E., Mattila S. Recurrence and malignant transformation of endotracheal chondroma. Ann Thorac Surg 1990;49(5):830-2. DOI: 10.1016/0003-4975(90)90039-9.

8. Leach K.R., Martinez FJ., Morelock J.W et al. Dyspnea and tracheal mass in an elderly man. Chest 1994;105(5):1555-6. DOI: 10.1378/chest.105.5.1555.

9. Farrell M.L., Gluckman J.L., Biddinger P. Tracheal chondrosarcoma: a case report. Head Neck 1998;20(6):568-572. DOI: 10.1002/(SICI)1097-0347(199809)20:6<568::AID-HED13>3.0.CO;2-D.

10. Kiriyama M., Masaoka A., Yamakawa Y. et al. Chondrosarcoma originating from the trachea. Ann Thorac Surg 1997;63(6):1772—3. DOI: 10.1016/S0003-4975(97)00331-7.

11. Maish M., Vaporciyan A.A. Chondrosarcoma arising in the trachea: a case report and review of the literature. J Thorac Cardiovasc Surg 2003;126(6):2077-80. DOI: 10.1016/S0022-5223(03)00949-8.

12. Umezu H., Tamura M., Kobayashi S. et al. Tracheal chondrosarcoma. Gen Thorac Cardiovasc Surg 2008;56(4):199—202. DOI: 10.1007/s11748-007-0218-3.

13. Wagnetz U., Patsios D., Darling G. et al. Tracheal chondrosarcoma — a rare complication in Maffucci syndrome. Br J Radiol 2009;82(981):e178—81. DOI: 10.1259/bjr/17386896.

14. Mendonija V., Jorge M., Monteiro-Grillo I. et al. Tracheal chondrosarcoma. Clin Translation Oncol 2010;12(8):576—80. DOI: 10.1007/s12094-010-0557-x.

15. De Almeida J.R., Pagedar N.A., Keshavjee S., Gilbert R. Chondrosarcoma of the trachea in a patient with Maffucci syndrome. J Otolaryngol Head Neck Surg 2010;39(2):E12-5. DOI: 10.2310/7070.2010.090194.