A Case of primary tracheal small cell carcinoma treated with concurrent chemoradiotherapy = A Case of primary tracheal small cell carcinoma treated with concurrent chemoradiotherapy

다국어 초록 (Multilingual Abstract)

Introduction: Extrapulmonary small cell carcinoma (EPSCC) can arise in multiple organs and form a rare clinical entity of high-grade neuroendocrine tumors. EPSCC is often confused with metastatic SCLC. But, primary tracheal small cell carcinoma (SCC) is different from primary SCLC with metastatic disease. We report a case with primary tracheal SCC that was successfully treated with concurrent chemoradiotherapy. Case: A 73-year-old male patient with dyspnea lasting for 10-day visited our hospital. The patient had old tuberculosis and was a current smoker. There was inspiratory stridor and chest X-ray revealed narrowing of tracheal air column at T2-3 level. Chest computed tomography (CT) revealed a lobulated mass at proximal trachea. Bronchoscopy showed a 4.2 × 3.1 cm sized mass 5 cm above the carina. Biopsy was performed and SCC was revealed. Positron emission tomography revealed no nodal or distant metastasis. The patient received 6 cycles of systemic chemotherapy with etoposide and cisplatin. Concurrent radiotherapy to the tracheal mass was also performed. After therapy, bronchoscopy revealed only tracheal mucosa ulceration without tumor. Chest CT showed complete remission. 5 years after treatment, the patient is well being and no evidence of recurrence. Conclusions: We have diagnosed this patient as primary tracheal SCC. This is a very rare disease and it can be confused with metastatic SCLC. In a patient with primary tracheal SCC, it is possible to cure and to achieve long term survival with chemoradiotherapy.