Zhang Jiyan,Zhang Xi,Liu Teng,et al.Bronchoscopy interventional diagnosis and treatment of primary airway tumors in children:a clinical analysis[J].Journal of Clinical Pediatric Surgery,2025,(03):265-270.[doi:10.3760/cma.j.cn101785-202312034-012]
Click Copy

Bronchoscopy interventional diagnosis and treatment of primary airway tumors in children:a clinical analysis

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2025年03 Page: 265-270 Column: 论著 Date of publication: 2025-03-28
Author(s):
Zhang Jiyan1;  Zhang Xi1;  Liu Teng2;  Xiao Zhenghui3;  Huang Jianbao1;  Zhang Xinping3;  Zhang Jin1;  Duan Xiaojun1
1. Department of Respiratory, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University(Hunan Children’s Hospital), Changsha 410007, China;
2. Department of General Surgery, Hunan Chest Hospital, Changsha 410000, China;
3. Emergency Center, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University(Hunan Children’s Hospital), Changsha 410007, China
Keywords:
Child; Primary Airway Tumors; Respiratory Endoscope; Interventional Therapy
DOI:
10.3760/cma.j.cn101785-202312034-012
Abstract:
Objective To summarize the clinical characteristics of primary airway tumors in children and to evaluate the effectiveness and safety of bronchoscopic interventional diagnosis and treatment for these tumors.Methods This retrospective study included 10 pediatric patients diagnosed with primary airway tumors who were hospitalized at Hunan Children’s Hospital between January 2019 and September 2023.Clinical symptoms,imaging findings,pathological results,bronchoscopic interventional treatment methods,and patient outcomes were collected and analyzed.Results Among the 10 patients,there were 6 males and 4 females,with an onset age ranging from 1 month and 16 days to 12 years and 5 months.The duration of symptoms varied from 15 to 180 days.Clinical symptoms included cough (n=7),hoarseness (n=4),stridor (n=3),wheezing (n=3),fever (n=2),and hemoptysis (n=1).The tumor locations were:larynx (n=6,including 4 in supraglottic and epiglottic regions,and 2 in the subglottic region),trachea and bronchi (n=4,including 1 in the trachea,1 in the left main bronchus,1 in the right main bronchus,and 1 in the right middle lobe bronchus).Tumor pathology included subglottic hemangioma (n=2),laryngeal papilloma (n=4),adenoma (n=1),mucoepidermoid carcinoma (n=2),and inflammatory myofibroblastic tumor (n=1).All patients underwent bronchoscopic diagnosis and treatment.The 2 cases of subglottic hemangioma showed improvement with oral propranolol therapy.The 4 cases of laryngeal papilloma required multiple surgical treatments.One patient with adenoma underwent bronchoscopic intervention and remained recurrence-free during 30 months of follow-up.The 2 cases of mucoepidermoid carcinoma and 1 case of inflammatory myofibroblastic biopsy and partial tumor resection,followed by surgical resection.The three patients who underwent surgical treatment were followed up for 18,30,and 36 months,respectively,with no severe intraoperative or postoperative complications such as massive hemorrhage and pneumothorax.Conclusions Primary airway tumors in children present with non-specific symptoms,leading to frequent misdiagnoses and missed diagnoses.Bronchoscopic intervention plays a crucial role in obtaining pathological confirmation and serves as a valuable tool in preparing for definitive surgical treatment in cases of malignant airway tumors.

References:

[1] Girvin F,Phan A,Steinberger S,et al.Malignant and benign tracheobronchial neoplasms:comprehensive review with radiologic,bronchoscopic,and pathologic correlation[J].Radiographics,2023,43(9):e230045.DOI:10.1148/rg.230045.
[2] Neville HL,Hogan AR,Zhuge Y,et al.Incidence and outcomes of malignant pediatric lung neoplasms[J].J Surg Res,2009,156(2):224-230.DOI:10.1016/j.jss.2009.03.100.
[3] Varela P,Pio L,Brandigi E,et al.Tracheal and bronchial tumors[J].J Thorac Dis,2016,8(12):3781-3786.DOI:10.21037/jtd.2016.12.67.
[4] Pio LC,Varela P,Eliott MJ,et al.Pediatric airway tumors:a report from the International Network of Pediatric Airway Teams (INPAT)[J].Laryngoscope,2020,130(4):E243-E251.DOI:10.1002/lary.28062.
[5] Cho HJ,Yoon J,Lee E,et al.The different clinical aspects of pediatric primary airway tumors in the larynx,trachea,and bronchi[J].J Korean Med Sci,2017,32(8):1304-1311.DOI:10.3346/jkms.2017.32.8.1304.
[6] Lee EY,Zucker EJ,Restrepo R,et al.Advanced large airway CT imaging in children:evolution from axial to 4-D assessment[J].Pediatr Radiol,2013,43(3):285-297.DOI:10.1007/s00247-012-2470-7.
[7] 王洪琴,黄敏,胡彬雅,等.儿童喉乳头状瘤临床特征及手术疗效分析[J].临床小儿外科杂志,2023,22(10):966-970.DOI:10.3760/cma.j.cn101785-202301017-012. Wang HQ,Huang M,Hu BY,et al.Clinical features and operative efficacies of juvenile onset laryngeal papilloma[J].DOI:10.3760/cma.j.cn101785-202301017-012.
[8] 高星,占小俊,谷庆隆.婴幼儿喉部血管瘤治疗进展[J].临床耳鼻咽喉头颈外科杂志,2023,37(12):972-976.DOI:10.13201/j.issn.2096-7993.2023.12.009. Gao X,Zhan XJ,Gu QL.Advances in the treatment of infantile hemangiomas of the larynx[J].J Clin Otorhinolaryngol Head Neck Surg,2023,37(12):972-976.DOI:10.13201/j.issn.2096-7993.2023.12.009.
[9] 黄莉,刘鸿圣,田金生.儿童原发性大气道肿瘤的CT表现[J].影像诊断与介入放射学,2021,30(3):206-211.DOI:10.3969/j.issn.1005-8001.2021.03.007. Huang L,Liu HS,Tian JS.Clinical and CT features of primary airway tumors in children[J].Diagn Imaging Interv Radiol,2021,30(3):206-211.DOI:10.3969/j.issn.1005-8001.2021.03.007.
[10] Hetzel J,Hetzel M,Hasel C,et al.Old meets modern:the use of traditional cryoprobes in the age of molecular biology[J].Respiration,2008,76(2):193-197.DOI:10.1159/000135934.
[11] Piccione J,Hysinger EB,Vicencio AG.Pediatric advanced diagnostic and interventional bronchoscopy[J].Semin Pediatr Surg,2021,30(3):151065.DOI:10.1016/j.sempedsurg.2021.151065.
[12] 张慧珊,陈熙泼,叶乐平,等.经支气管镜冷冻介入在儿童气管支气管结核诊疗中的临床应用[J].中华儿科杂志,2021,59(11):963-967.DOI:10.3760/cma.j.cn112140-20210504-00378. Zhang HS,Chen XP,Ye LP,et al.Clinical application of transbronchial cryotherapy in the diagnosis and treatment of tracheobronchial tuberculosis in children[J].Chin J Pediatr,2021,59(11):963-967.DOI:10.3760/cma.j.cn112140-20210504-00378.
[13] Tan JHY,Takano AM,Hsu AAL.Resection with preserved histologic morphology of a rare tumour via bronchoscopic cryosurgery[J].J Thorac Dis,2016,8(10):2964-2967.DOI:10.21037/jtd.2016.10.08.
[14] Hetzel J,Eberhardt R,Herth FJF,et al.Cryobiopsy increases the diagnostic yield of endobronchial biopsy:a multicentre trial[J].Eur Respir J,2012,39(3):685-690.DOI:10.1183/09031936.00033011.
[15] 陶红艳,马甜甜,万毅新,等.儿童支气管黏液表皮样癌一例并误诊分析[J].中国医学科学院学报,2020,42(5):706-710.DOI:10.3881/j.issn.1000-503X.11876. Tao HY,Ma TT,Wan YX,et al.Bronchial mucoepidermoid carcinoma in children and its misdiagnosis:report of one case[J].Acta Acad Med Sin,2020,42(5):706-710.DOI:10.3881/j.issn.1000-503X.11876.
[16] Dhochak N,Mittal S,Jain D,et al.The first report of pediatric endobronchial cryobiopsy:expanding horizon of bronchoscopic cryotherapy for airway tumors[J].Pediatr Pulmonol,2021,56(9):3051-3053.DOI:10.1002/ppul.25542.
[17] 吴上志,陈德晖.经支气管镜冷冻技术在儿科呼吸系统疾病中的应用[J].中国小儿急救医学,2024,31(8):566-570.DOI:10.3760/cma.j.issn.1673-4912.2024.08.002. Wu SZ,Chen DH.Application of transbronchoscopic freezing technique in pediatric respiratory diseases[J].Chin Pediatr Emerg Med,2024,31(8):566-570.DOI:10.3760/cma.j.issn.1673-4912.2024.08.002.
[18] 焦安夏.现代儿科呼吸介入技术在呼吸系统肿瘤的应用进展[J].中国实用儿科杂志,2020,35(10):776-778.DOI:10.19538/j.ek2020100608. Jiao AX.Application progress of modern pediatric respiratory intervention techniques in respiratory system tumor[J].Chin J Pract Pediatr,2020,35(10):776-778.DOI:10.19538/j.ek2020100608.
[19] Bertino G,Pedretti F,Mauramati S,et al.Recurrent laryngeal papillomatosis:multimodal therapeutic strategies.Literature review and multicentre retrospective study[J].Acta Otorhinolaryngol Ital,2023,43(S1):S111-S122.DOI:10.14639/0392-100X-suppl.1-43-2023-14.
[20] Hao F,Yue LY,Yin XY,et al.Low-temperature radiofrequency coblation reduces treatment interval and post-operative pain of laryngotracheal recurrent respiratory papillomatosis[J].Biosci Rep,2020,40(5):BSR20192005.DOI:10.1042/BSR20192005.
[21] Bowles PF,Liu A,Harries ML.CO2 laser "Ablation Suction" technique for treatment of laryngeal recurrent respiratory papillomatosis[J].Clin Otolaryngol,2019,44(5):884-885.DOI:10.1111/coa.13278.
[22] U?ur Chousein EG,Turan D,?zgül MA,et al.Secondary pulmonary malignancies requiring interventional bronchoscopic procedures[J].Turk Gogus Kalp Damar Cerrahisi Derg,2021,29(3):360-369.DOI:10.5606/tgkdc.dergisi.2021.19927.
[23] Elleuch R.Bronchoscopic treatment of malignant central airway obstruction:a cohort study,long-term survival and complications[J].Rev Mal Respir,2022,39(6):505-515.DOI:10.1016/j.rmr.2022.04.004.
[24] Inomata M,Kuroki S,Oguri N,et al.Pleomorphic adenoma of the trachea:a case report[J].Int J Surg Case Rep,2023,109:108499.DOI:10.1016/j.ijscr.2023.108499.
[25] Yang HM,Yin J,Tang XL,et al.Clinical significance of interventional therapeutic bronchoscopy combined with bronchial arterial embolization in the treatment of hypervascular primary airway tumors in children[J].Pediatr Investig,2021,5(2):130-135.DOI:10.1002/ped4.12256.

Memo

收稿日期:2023-12-15。
基金项目:儿童急救医学湖南省重点实验室(2018TP1028);湖南省卫生健康委科研计划课题(202206013971)
通讯作者:段效军,Email:dxj801010@126.com

Last Update: 2025-03-28