Adenoid Cystic Carcinoma of the Upper Trachea: A Rare Neoplasm
A 42-year-old male patient presents with a 6-month history of dyspnea. General physical examination did not reveal any significant abnormality. He had no history of smoking. The hematological and biochemical profile were essentially normal. Chest radiograph was within normal limits. Plain lateral radiograph of the neck revealed a broad-based polypoidal mass arising from the posterior wall of the proximal trachea []. Bronchoscopy confirmed the neoplasm. Histopatholgical examination of the mass confirmed it to be an ACC []. Patient suddenly developed severe respiratory distress and change of voice for which emergency tracheostomy was performed. CT and MRI were advised for treatment planning. MDCT [Figures and ] revealed a broad-based polypoidal soft tissue mass arising from the posterior wall of the proximal end of the trachea just below the cricoid cartilage and extending to involve the subglottis resulting in near total luminal obstruction. The tracheal mass eroded the tracheal cartilage and was abutting the right lobe of the thyroid. MRI [Figures and ] confirmed almost similar findings like CT. Metastatic work up which included CT thorax, abdominal ultrasound, and bone scan were normal. Surgical resection of the tumor was planned. Because of laryngeal extension, total laryngectomy and end-tracheostomy was performed in addition to resection of the tracheal segment. Histopathological examination of the surgical specimen confirmed the diagnosis of ACC. The patient also received external beam radiation therapy following surgery. The patient was on regular follow-up after the treatment. Follow-up of the patient after 18 months post-treatment did not reveal local recurrence or distant metastases.