Intratracheal Neurilemmoma in a Child Treated as Bronchial Asthma
for Two Years : Importance of Radiologic Studies

Makiko Nakamura, Yoshiaki Harada, Kenji Teranishi, Kaoru Ookawa
Shouichi Ooue^1）, Masao Okamura^2）, Kazunari Kaneko^3）
Department of Pediatrics and Radiology^1）, Kyoujinkai Komatsu Hospital
Department of Surgery, Aijinkai Takatsuki Hospital^2）
Department of Pediatrics, Kansai Medical University^3）

Abstract
A 14-year-old girl who had been treated for bronchial asthma for 2 years was admitted to our hospital because of dyspnea. Her signs and symptoms did not improve and respiratory distress developed despite standard therapy for an asthmatic attack. On further examination to rule out a possible obstructive lesion of her airway, a lateral view neck X-ray was performed and the findings suggested the presence of an intratracheal tumor, which was confirmed by computed tomography. Bronchoscopic tumorectomy resulted in dramatic improvement of her respiratory condition. The histology of the tumor was consistent with neurilemmoma (Schwannoma).
Though primary tracheal neurilemmoma is extremely rare (only 9 cases in the literature) and it is difficult to make a diagnosis, we pediatricians should have a high index of suspicion in case of an intractable asthmatic attack, because reported clinical signs and symptoms mimic those of asthmatic attack. Radiographic examinations are helpful for the diagnosis.

Keywords： Intractable bronchial asthnma, Intratracheal tumor, Neurilemmoma