Endotracheal Resection of a Mucous Retention Cyst

A 58-year-old man with a recent stroke presented with neck pain and dysphagia. He underwent a CT scan of the thorax, which demonstrated a polypoid lesion in the trachea. He had no other significant past medical history other than hypertension. He was offered surgical excision of the lesion.

Under direct laryngoscopy, a 0 degree thoracoscope was passed into the trachea. A large, smooth lesion was seen in the distal trachea, occupying the majority of the tracheal lumen. The lesion was separated from the tracheal wall using low energy cautery. Upon dissection, the lesion ruptured and mucous material was released. Diathermy cautery dissection was continued to remove the cystic lesion and was removed in its entirety. Bleeding was controlled with a combination of diathermy. Endobronchial suction was used to clear the airways.

The patient made a good recovery. Histopathology of the lesion confirmed that this was a mucous retention cyst.

Reference

Krishtafovich A, Ariel BM. Exocrine gland cysts in tracheal and bronchial walls. Lung Breath J. 2018:2(3);1-3.