Tracheal neurofibroma treated by repeated flexible bronchoscopic cryotherapy: A case report

Rationale: Isolated endotracheal neurofibroma is very rare. The majority of neurofibromas are benign, but rarely, they can become cancerous. Furthermore, symptomatic neurofibroma is usually treated by surgical resection. Recently, several alternative options for surgical resection of this airway pathology have been suggested and developed, including bronchoscopic cryotherapy. Nevertheless, there has been no report on the application of repeated flexible bronchoscopic cryotherapy to remove an endotracheal neurofibroma. Patient concerns: A 65-year-old woman presented with progressive dyspnea and productive cough. Chest computed tomography scans revealed a 1.5-cm polypoid-shaped mass with fat attenuation and mild enhancement in the distal trachea. Flexible bronchoscopic cryotherapy was performed to remove the mass and confirm the diagnosis. Diagnosis: Pathologically, the mass was diagnosed as an endotracheal neurofibroma occupying the distal tracheal lumen. Interventions: The endotracheal neurofibroma was completely removed with repeated flexible bronchoscopic cryotherapy instead of surgical resection. Outcomes: Follow-up flexible bronchoscopy also revealed that there was no regrowth of the neurofibroma. Up to 18 months after the completion of serial cryotherapy, the patient had no recurrent symptoms or complaints. Lessons: Flexible bronchoscopic cryotherapy can be performed repeatedly for therapeutic purposes for airway tumors. It is recommended to consider flexible bronchoscopic cryotherapy as an alternative therapeutic option for patients with central airway obstruction due to tumorous lesions such as neurofibromas.