Tracheal papillomas are rare tracheal tumors. These tumors are usually benign and present with signs and symptoms of air way obstruction and hemoptysis. This is a disease predominantly seen in infants and children and is usually associated with laryngeal papillomatosis. The clinical manifestations are diverse and the disease is rarely considered in the differential in adult patients with hemoptysis. We present a rare case of isolated tracheal papillomatosis presenting with hemoptysis and a brief review of literature. Introduction Tracheal papillomas are rare tracheal tumors. These tumors are usually benign and present with signs and symptoms of air way obstruction and hemoptysis. This is a disease predominantly seen in infants and children and is usually associated with laryngeal papillomatosis. The clinical manifestations are diverse and the disease is rarely considered in the differential in adult patients with hemoptysis. We present a rare case of isolated tracheal papillomatosis presenting with hemoptysis and a brief review of literature. Case Report A 55 year-old Hispanic male was referred to pulmonary clinic with history of dry cough for 3 months. Cough was paroxysmal and associated with episodes of mild hemoptysis (approximately a tea-spoon) each time at the end of his coughing episode. These episodes ranged 6-8 per day. He denied fever, chest pain and shortness of breath. He was a former cigarette smoker (50 pack-years) and had quit 7 years ago. Occupational and travel history were unremarkable. Physical examination was normal. There was no clubbing, stridor or ronchi. Chest x-ray and CT scan revealed absence of parenchymal and endobronchial lesions (figure 1 & 2). The patient underwent flexible fiberoptic bronchoscopy (FFB) to rule out endobronchial lesion as a cause of his hemoptysis. Bronchoscopy revealed multiple white shiny glistening lesions at the 3rd tracheal ring (Figure 3). The upper air way including larynx and the rest of the tracheobronchial tree was normal. Endobronchial biopsies of the lesions revealed squamous papilloma. (Figure 4)
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