Sudden natural asphyxial death in adults due to airway obstruction is an unusual cause of death. A variety of etiologies can cause airway obstruction, including benign or malignant tumors and soft tissue swelling from asthma, infections, or anaphylaxis.
Malignant tracheal neoplasms are exceedingly rare with a reported incidence of approximately 2/1 000 000 and the small cell carcinoma subtype accounts for <10% of these tumors.
We present a case of a 55-year-old female smoker who was found dead at home. At autopsy an obstructing lesion of the proximal trachea was identified that showed the characteristic cytomorphology of small cell carcinoma. No primary pulmonary lesions were identified. The cause of death was determined to be obstruction of the trachea by small cell carcinoma and the manner, natural.
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