Metastasis at a tracheostomy site as the presenting sign of late recurrent breast cancer

Head Neck. 2013 Nov;35(11):E359-62. doi: 10.1002/hed.23234. Epub 2013 Mar 18.


Background: Metastasis in a tracheostomy site occurs rarely, usually from head and neck primary tumors. Breast cancer relapse to a tracheostomy has not been described to date.

Methods and results: A 71-year-old women presented with symptoms typical of central airway obstruction, 10 years after mastectomy for breast cancer. Fifteen months before admission, when cancer follow-up was negative, she also had surgery for cerebral aneurysm and a tracheostomy. On admission, CT showed a solid mass infiltrating the tracheostomy tract and projecting into the airway. Tracheal obstruction palliation was achieved by laser resection of the endotracheal growth and stenting. Histology documented breast cancer metastasis.

Conclusions: Tracheostomy site metastasis was the presenting sign of late-onset relapse of breast cancer. This case supports the concept of surgery-driven interruption of micrometastatic cancer dormancy, in that the initial recurrence developed in a tracheostomy that was surgically created several years after resection of the primary tumor.

Keywords: breast cancer; dormancy; laser resection; metastasis; tracheostomy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Biopsy, Needle
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Bronchoscopy / methods
  • Carcinoma, Ductal, Breast / secondary*
  • Carcinoma, Ductal, Breast / surgery
  • Disease Progression
  • Fatal Outcome
  • Female
  • Humans
  • Immunohistochemistry
  • Mastectomy / methods
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / surgery
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / etiology
  • Risk Assessment
  • Stroke / diagnosis
  • Stroke / therapy
  • Time Factors
  • Tracheal Neoplasms / pathology
  • Tracheal Neoplasms / secondary*
  • Tracheal Neoplasms / surgery
  • Tracheal Stenosis / diagnosis
  • Tracheal Stenosis / etiology
  • Tracheostomy*