Tracheal Mass
Sudhakar Pipavath, MD
DIFFERENTIAL DIAGNOSIS
Common
Metastasis
Primary Tracheal Neoplasms
Squamous Cell Carcinoma
Adenoid Cystic Carcinoma
Mucus
Less Common
Mucoepidermoid Carcinoma
Tracheobronchopathia Osteochondroplastica (TBO)
Rare but Important
Amyloidosis
ESSENTIAL INFORMATION
Key Differential Diagnosis Issues
Malignant until proven otherwise
Malignant features of tracheal mass include
Size more than 2 cm
Extraluminal component can be quite large
Invasion of surrounding structures
Helpful Clues for Common Diagnoses
Metastasis
Direct invasion from adjacent tumors arising from lung, thyroid, and esophageal primary tumors
Metastasis from other distant primaries (e.g., melanoma) less common
Primary Tracheal Neoplasms
Squamous Cell Carcinoma
Focal mass or diffuse nodular wall thickening
Adenoid Cystic Carcinoma
Common in young adults (age range: 30-56 years)
Extraluminal component is characteristic
Diffuse infiltration with submucosal extension
Mucus
Generally not dense enough to be well seen on soft tissue window
Can demonstrate mobility with changing image position or coughing
Helpful Clues for Less Common Diagnoses
Mucoepidermoid Carcinoma
Majority of patients are less than 30 years
Imaging features similar to other primary tracheal tumors
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