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From 1970 to 1993, 196 patients with thyroid cancer were treated surgically. In 26 (13.2%) an invasion of local and regional structures was observed. Eighteen patients had papillary or follicular carcinoma and 9 anaplastic carcinoma. Tracheal invasion occurred in 11 cases and 7 patients underwent total thyroidectomy, segmental resection of the trachea (1-5 rings) and reanastomosis, associated preoperatively in 2 cases with Nd:YAG laser photocoagulation. Six of thirteen patients with muscle invasion are alive at 2-16 years follow-up; 3 patients with tracheal invasion died in less than 6 months and the others seem to be free of disease 6-14 years after operation.

On the possible ontogeny of the cells of a "granular cell tumor" of the human trachea. In a young patient affected with pulmonary tuberculosis during bronchoscopy a "granular cell tumor" of the membranous part of trachea was occasionally evidentied. After pathologic examination, the specimen is analyzed in order to assess the kind of cells that are present in the lesion: the ultrastructural and immunohistochemical study shows Schwann cells which particularly well developed lysosomal complement.

Secondary tumors of the trachea are exceedingly rare, only 14 cases having been reported in the literature. Moreover, metastatic involvement of naso-paranasal cavities can be considered quite unusual. Approximately 150 cases have been drawn from the literature, most of which presented a metastatic deposit from a renal adenocarcinoma. Report is then made of a case of cutaneous melanoma metastatic to the trachea and nasal cavity. The tracheal lesion was repeatedly treated with Nd Yag laser, whereas no treatment was considered eligible for nasal metastasis. The patient succumbed to the tumor 16 months after diagnosis of tracheal involvement had been made. The tendency for malignant melanomas to metastasize to distant organs via the bloodstream is well known, yet trachea and nasoparanasal involvement by metastatic melanoma has been reported, respectively, in only three and six cases, including the present one. Prognosis is unfavorable due to the unusual coexistence of metastases to other organs and the lack of an adequate treatment.

The Authors report two cases of tracheal tumor operated with laryngeal release and tracheal mobilization following Dedo and Fishman. They discuss the indications and describe this technical procedure which has proved successful in obtaining a suture without traction also for 4 cm sleeve resection of trachea.