Trachea cancer

Description:

From malignant tumors of a trachea cancer and sarcoma of a trachea meet. In literature the small number of observations of cancer tumors of a trachea is published.

Trachea Cancer symptoms:

As well as benign tumors, trachea cancer till the known time proceeds asymptomatically. Usually sick breath difficulty forces to address the laryngologist. From now on it also estimates duration of the disease, coming to the doctor approximately in 5-6 months after its beginning.

In the beginning an asthma is noticeable only at a physical tension, then becomes more expressed; at last, the patient can be only in a certain forced situation (sedentary). Breath becomes noisy, and the breath or an exhalation is followed by a stridor. Until the wall of a trachea is capable to extend at a breath, the stridor has expiratory character. When it becomes rigid, also the breath is at a loss. Character of a stridor depends on localization of a tumor. New growths of upper parts of a trachea, as well as a throat tumor, sometimes are followed by an inspiratory asthma; narrowing of a trachea within a thorax causes preferential expiratory asthma.

Earlier, than breath difficulty, at cancer of a trachea appears cough. It often has pristupoobrazny, painful character. At first cough dry, further it is followed by expectoration of a phlegm. The phlegm accepts purulent character, is allocated hardly, sometimes separates in a large number at once. From time to time cough decreases or even disappears at all. Such nature of cough gives a reason for wrong diagnosis of bronchial asthma.

It is necessary to refer availability of blood in a phlegm to important symptoms of cancer of trachea. The pneumorrhagia appears periodically and can be short-term.

Frustration of a phonation (osiplost, hoarseness, aphonia) at trachea cancer - a usual symptom. It is explained by involvement in process of recurrent nerves. At a laringoskopiya in this case the cadaveric provision of one or both phonatory bands is noted. Disturbance of a voice can be referred also due to reduction of an air stream (at a tracheostenosis).

Germination of a wall of a gullet is followed by pains and a delay of food in it. When the tumor begins to break up, the phlegm gets an unpleasant smell, bleeding develops. In a phlegm during this period cancer cells are found.

From the general phenomena in the started cases are noted the increased temperature accelerated by SOE, reduction of number of erythrocytes, a deviation to the left.

Trachea Cancer reasons:

Malignant tumors of a trachea are subdivided on primary and secondary.

Primary develop from a trachea wall, secondary represent growing into a trachea of malignant tumors of the next bodies: throats, thyroid gland, lung and bronchial tubes, gullet, lymph nodes, mediastinum.

Primary malignant tumors of a trachea make 0,1-0,2% of all malignant new growths. The most common histologic forms are adenokistozny cancer (tsilindroma) and the planocellular cancer making 75-90% of all malignant tumors of a trachea. At the same time the frequency of adenokistozny cancer is slightly higher, than planocellular.

Primary tumors of a trachea meet more often at men, than at women, is preferential aged from 20 up to 60 years.

At children over 90% of tumors of a trachea are high-quality, and at adults benign and malignant tumors meet approximately identical frequency.

Tsilindroma develop from an epithelium of mucous glands of a trachea, are characterized by infiltriruyushchy growth, recur after removal and metastasize.
However these tumors develop slowly, and patients sometimes live with a tumor within 3-5 and more years.

Planocellular cancer proceeds more often from side and back walls of a trachea and makes a half of all tumors of this localization. At men it is observed almost twice more often. Patients prevail 40 years are more senior. Growth rate of a tumor, as a rule, small and a disease can be shown by nothing within 1-2 years.

Sarcoma of a trachea is usually localized in the field of bifurcation (bifurcation of the trachea) and happens fusocellular and kruglokletochny. The ulceration, disintegration and innidiation are observed only in late stages. In a trachea also benign tumors quite often are exposed to sarkomatozny transformation.

From an epithelium of a mucous membrane and mucous glands in a wall of a trachea carcinoids and mucoepidermoid adenomas which meet more often at young women can develop.

Treat rare malignant tumors of a trachea: a reticulosarcoma, a reticuloendothelioma, a gemangioperitsitoma, a gemangioendotelioma, a malignant neurofibroma, the isolated lymphogranulomatosis (Hodzhkin's disease), a tumorous form of a chronic lymphoid leukosis or a leukemic reticulosis.

Innidiation of malignant tumors of a trachea is observed infrequently since patients die of asphyxia (suffocation) and other complications.

Damage of regional (nearby) lymph nodes is typical.
The remote metastasises can be revealed in a thyroid gland, a pleura, lungs, a liver, kidneys, adrenal glands, a peritoneum, a pancreas, a backbone, edges, skin and even in heart.

A bigger rarity is innidiation in a trachea of malignant tumors of other bodies. Such cases are described at cancer of a kidney, uterus, ovaries and a large intestine.

Cancer in upper or lower and, much more rare, on average department of a trachea is localized. Being located over bifurcation, the tumor closes a gleam of both bronchial tubes.

The cancer tumor can proceed from any wall of a trachea. The tumor can be flat, with the wide basis, or is considerable act in a gleam of a trachea and narrow it. Infiltrate happens hilly, reminding the bleeding granulations. At last, the new growth in certain cases has character of ring-shaped infiltrate. On a histologic structure in most cases cancer of a trachea concerns to planocellular crayfish with keratinization or without it. More seldom the adenocarcinomas developing from a superficial cylindrical epithelium or from mucous glands meet.

Trachea walls at a malignant tumor become rigid. The tumor provided to itself burgeons in a gullet, a thyroid gland, gives metastasises in paratracheal and cervical lymph nodes, extends to soft tissues of a neck.

Cancer therapy of a trachea:

Cancer therapy of a trachea combined: operational removal with the subsequent radium - and a roentgenotherapy. Operational treatment comes down to excision of a tumor within healthy fabric. At circular defeat the cross resection of a part of body becomes. Availability to a radical operative measure is defined by the level of localization of a tumor; it is more difficult for those, than the tumor is located below. The most lower parts are unavailable to an operative measure. After partial removal of a wall of a trachea defects are replaced by means of plastic surgeries. At circular resections the ends of a trachea approach and sewed. At the same time there is always a danger of discrepancy of seams, for the prevention of what the patient's head at first after operation is fixed in inclined situation.

When completely it is not possible to remove a tumor, palliative operations are applied. First of all the trakheofissura at which several rings of a trachea over a tumor are cut concerns to them and the last leaves nippers, an acute spoon or an electroknife.

Quite often at an advanced carcinoma of a trachea it is necessary to be limited to tracheotomy. T. I. Gordyshevsky notices, as this operation at tumors of a trachea is connected with dangers. When the tumor occupies the most part of a gleam of a trachea, the patient breathes through a narrow crack at a certain position of the head; change of this situation at tracheotomy, and also introduction of a dilator or tracheotomic tube through tumoral masses can cause instant death. Therefore tracheotomy is recommended to be made in a semi-sitting position and at high localization of a tumor to open a trachea below the place of narrowing. In all other cases of operation (across Gordyshevsky) begin with a cricotomy. Then there are visible tumor contours at its upper pole and an entrance to a free crack through which the patient breathes. The metal tube is entered into this crack long, to a bronchial tube, and after that in a quiet situation the subsequent manipulations on a trachea are made.

After radical excision of a tumor you apply radiation therapy. It is necessary to be limited to it at those patients where term for operational removal is missed. One beam treatment appears insufficiently, and, despite the seeming improvement after a course of treatment, soon there comes the recurrence.

Sarcoma meets in a trachea exclusively seldom. As primary it appears as a result of regeneration of benign connective tissue tumors. Secondary tumors happen in a trachea as a result of germination of sarcoma of a thyroid gland or lymph nodes. On a clinical current trachea sarcoma differs from cancer a little.

The forecast at cancer of a trachea is very serious. At the late request of patients for medical assistance the prediction worsens. T. I. Gordyshevsky connects the forecast with the nature of a tumor; at a tsilindroma, in his opinion, the forecast more favorable.