Emergency resection of tracheal inflammatory myofibroblastic tumour in a young adult: Case Report

Abstract

Introduction: Inflammatory myofibroblastic tumour (IMT) is a rare benign lesion occurring mainly in children and adolescents. Airway involvement, particularly of the trachea, is exceptional and poses risk of suffocation. We describe a young adult presenting with near‑fatal obstruction who required urgent surgical management.

Case report: A 20‑year‑old non‑smoker developed progressive hoarseness and exertional breathlessness over three months, culminating in severe inspiratory stridor. Spirometry showed fixed upper‑airway blockage. Computed tomography demonstrated an intraluminal mass obliterating more than 90 % of the subglottic trachea and severe hypercapnia was confirmed. A 5 mm tube was railroaded over a bronchoscope to bypass the lesion, followed by cervical resection of the affected segment with primary anastomosis. Histology confirmed IMT. Recovery was uneventful; six‑month review revealed normal spirometry and no recurrence.

Discussion: Misdiagnosis as asthma is common when IMTs narrow the airway gradually. Prompt recognition of fixed obstruction should trigger imaging and bronchoscopy. Complete resection remains the definitive therapy, even in emergencies, and gives excellent outcomes with clear margins. Adjuvant treatment is reserved for unresectable or recurrent disease. This case underlines the need to consider tracheal tumours in young adults with unexplained stridor and shows that timely surgery can reverse life‑threatening hypercapnia while preserving long‑term airway function. Long‑term surveillance with bronchoscopy remains essential because recurrences have been described.