Case Series of Tracheal Cancer Subsequent to Primary Lung Cancer Surgery

Background. Tracheal malignancies are exceedingly rare. Sometimes, it may take several months to detect and diagnose them. We herein report three cases of tracheal cancer identified during the follow-up after primary lung cancer surgery. Case 1. An 81-year-old female patient underwent right middle and lower lung lobectomy for squamous cell carcinoma (SqCC) of the right lower lung lobe. Three and a half years post-surgery, an abnormal thickness in her trachea was observed on chest computed tomography (CT). Following bronchoscopy, she received a diagnosis of tracheal cancer. Case 2. An 81-year-old male patient underwent right lower lung lobectomy for SqCC of the right lower lung lobe. Two and a half years post-surgery, despite the initial focus being on another small nodule in the left lung lower lobe, 18F-fluorodeoxyglucose positron emission tomography revealed a high fluorodeoxyglucose uptake around his trachea. Following bronchoscopy, he received a diagnosis of tracheal cancer. Case 3. A 73-year-old male patient underwent left lower lung lobectomy for SqCC of the left lower lung lobe. Approximately six years post-surgery, a large tumor extending from the trachea to the right cervical region was identified on chest CT. Following an ultrasound-guided biopsy, he received a diagnosis of tracheal cancer. Conclusion. We have encountered three cases of tracheal cancer following surgery for primary lung cancer. While diagnosing and distinguishing it is notably challenging, we should contemplate performing a biopsy upon detecting abnormal shadows in the trachea during imaging examinations.