RT Book, Section
A1 Bharat, Ankit
A1 DeCamp, Malcolm M.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170409388
T1 Resection of the Carina
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170409388
RD 2024/04/23
AB Airway  neoplasms  account  for  approximately  90%  of  carinal  resections.1  The  incidence  of  primary  tracheal  tumors  is  unclear,  but  is  known  to  be  rare.  A  recent  population-based  cancer  registry  analysis  using  the  SEER  database  demonstrated  an  incidence  of  2.6  tracheal  tumor  cases  per  1,000,000  people  per  year.2  Carinal  tumors,  as  a  subcategory  of  tracheal  tumors,  are  even  less  common.  Most  are  malignant  and  can  be  divided  into  bronchogenic  carcinoma  and  other  airway  neoplasms.  Bronchogenic  carcinomas  are  by  definition  malignant;  the  other  airway  neoplasms  may  exhibit  a  wide  range  of  behavior.  As  demonstrated  in  Table  63-1,  the  most  common  malignant  primary  tracheal  neoplasms  are  squamous  cell  carcinoma  (SCC)  and  adenoid  cystic  carcinoma  (ACC).3  SCC  occurs  primarily  in  smokers  in  their  sixth  and  seventh  decades  and  may  present  confined  to  the  trachea  or  invading  into  adjacent  mediastinal  structures.  ACC  is  an  exophytic  intratracheal  lesion,  which  may  involve  the  tracheal  wall  to  variable  extent  (Fig.  63-1)  and  may  compress  mediastinal  structures  without  invading  them  initially.  Lymph  node  metastases  occur,  but  less  commonly  than  in  SCC.  A  characteristic  feature  of  ACC  is  its  proclivity  for  extending  long  distances  submucosally  and  perineurally.