This is well written case report of a rare presentation of a rare condition. It provides a important reminder to consider a differential diagnosis in patients with asthma.
Large airway tumours are rare (0.2%) amongst patients with lung cancer, and amongst tracheal tumours it is thought that adenocarcinomas represent 4-10%.1-5 The majority of tracheal adenocaricinomas are diagnosed in smokers.3-4 In one case series of tracheal tumours 21% had symptoms of progressive bronchial asthma.5
Dr Ian Clifton
St James’s University
1. Li W, Ellerbroek NA, Libshitz HI. Primary malignant tumors of the trachea. A radiologic and clinical study. Cancer 1990;66:894–9.
2. Hajdu SI, Huvos AG, Goodner JT, et al. Carcinoma of the trachea. Clinicopathologic study of 41 cases. Cancer 1970;25:1448–56.
3. Gelder CM, Hetzel MR. Primary tracheal tumours: a national survey. Thorax 1993;48:688–92.
4. Licht PB, Friis S, Pettersson G. Tracheal cancer in Denmark: a nationwide study. Eur J Cardiothorac Surg 2001;19:339–45.
5. Houston HE, Payne WS, Harrison EG Jr, et al. Primary cancers of the trachea. Arch Surg 1969;99:132–40.
Adenocarcinoma: not all that wheezes is asthma