Primary tumours of the trachea: analysis of clinical features and treatment results.

Primary tracheal tumours are extremely rare and present with widely variant clinical and histological features. Treatment methods vary considerably, and few studies have sought to provide adequate guidelines. A retrospective analysis was carried out of all patients treated in our unit between 1965 and 1990. Our experience deals almost exclusively with high tracheal tumours involving the adjacent subglottic region. Squamous carcinoma (SCC) and adenoid cystic carcinoma (ACC) were the commonest subtypes, and presented with dyspnoea and hoarseness as the most frequent symptoms. ACCs occurred commonly in young individuals, presented insidiously, and ran a long, and often, unpredictable course. Endoscopic evaluation revealed the majority of the lesions to be bulky and obstructive in nature. Primary surgery with adjuvant radical radiotherapy, when indicated, appeared to provide optimal results. Debulking surgery followed by radiotherapy provided effective and lasting control in two cases of ACC. Other malignant subtypes behaved aggressively and progressed uncontrolled.