Key Points

• The majority of secondary airway tumors occur via direct extension of the trachea from nearby structures.
• A curative airway resection is possible in selected cases.

Metastatic tracheal lesions are much more common than primary tracheal tumors[1]. Secondary tumors invading the upper airway typically arise directly from adjacent structures. This includes direct invasion from the lung, thyroid, larynx, and esophagus. These tumors rarely present in a manner amenable to surgical resection due to disease burden. Further, symptoms are often vague and may be mistaken for other diagnoses such as asthma, chronic obstructive pulmonary disease, or pneumonia[2],[3]. The primary neoplasm is usually present on CT scan with contiguous extension to the airways with focal wall thickening, or endotracheobronchial mass[4]. Despite this, the situation occasionally arises in which resection of the trachea or carina is a consideration. In the case of non–small cell lung cancer (NSCLC), growing experience with stage T4 tumors in selected instances has suggested a role for aggressive surgical therapy.