Stridor of Recent Onset

History  A 56-year-old woman with a heavy smoking history was admitted to the hospital for stridor of three weeks' duration. An anteroposterior chest roentgenogram was obtained (Fig 1) (below), followed by mediastinal tomography (Fig 2) (right).

Diagnosis  Tracheogenic carcinoma.

Comment  The chest roentgenogram (Fig 1) shows severe narrowing of the trachea above the carina with slight widening of the mediastinum. There is loss of lung volume on the right and a right lower infiltrate. The mediastinal tomogram (Fig 2) shows a symmetrical concentric mass that has reduced the trachea lumen to a diameter of 3 mm.At fiberoptic bronchoscopy, a solid fusiform tumor narrowing the tracheal lumen was noted. A biopsy specimen disclosed a well-differentiated squamous cell carcinoma. Because of severe coronary artery disease, the patient was not a surgical candidate, and therefore was treated with radiotherapy and corticosteroids to reduce tracheal edema. The patient noted marked decrease in her