Tracheal schwannoma presenting as pneumonia: A rare case report in an adolescent.

Background: Tracheal schwannoma is a rare benign tumor originating from Schwann cells, and it is even less common in adolescents. The clinical manifestations are usually nonspecific respiratory symptoms such as cough and sputum production, which can easily be mistaken for infectious diseases. Imaging findings often suggest an inflammatory mass, making early diagnosis challenging. Case presentation: A 15-year-old female was admitted with a 3-day history of cough and sputum production and was initially diagnosed with community-acquired pneumonia. High-resolution chest CT and 3D reconstruction revealed a well-defined, mildly to moderately enhanced round nodule (approximately 1.1 × 0.7 cm) in the lower trachea, accompanied by bronchopneumonia. Imaging findings suggested an inflammatory myofibroblastic tumor or inflammatory granuloma. The lesion was completely resected under painless bronchoscopy. Histopathology showed spindle cells arranged in bundles, with strong positive staining for S-100 and SOX-10 and a Ki-67 proliferation index of about 5%, confirming the diagnosis of benign tracheal schwannoma. After postoperative anti-infective therapy, the patient's symptoms rapidly resolved. Conclusion: Although tracheal schwannoma is benign, it may initially present as pneumonia and mimic an inflammatory tumor on imaging, leading to diagnostic confusion. For adolescent patients with recurrent respiratory symptoms and poor response to conventional therapy, early chest CT and bronchoscopy should be considered. Bronchoscopic resection combined with anti-infective therapy can achieve excellent outcomes.