Tracheal obstruction caused by pleomorphic adenoma

A 49‐year‐old woman presented with severe dyspnoea and respiratory distress. She had a 2‐year history of progressively worsening wheezing and stridor and was diagnosed with asthma, but the symptoms did not resolve with bronchodilators and steroid inhalers. She had no previous history of respiratory disease. Emergency computed tomography scan showed severe tracheal stenosis (Figure, A and B, arrows). Bronchoscopy revealed a large vascular tuberculiform neoplasm with a smooth surface in the lower third of the trachea, with almost complete airway obstruction (Figure, C, arrow). Histopathology showed salivary gland pleomorphic adenoma. The patient underwent an endoscopic electrosurgical excision and recovered. Diagnosis of pleomorphic adenoma may be delayed because of the lack of specific symptoms or because the symptoms can mimic asthma.1