Multidisciplinary treatment for bronchial adenoid cystic carcinoma: An elderly case

Abstract

Bronchial adenoid cystic carcinoma may require multidisciplinary treatment due to its pathological features. It is difficult to determine preoperatively whether complete resection can be solely achieved by surgery. Furthermore, with the recent increase in the number of elderly patients with lung cancer, it is important to evaluate the outcome of each patient and control the disease by multidisciplinary treatment without compromising the patient's quality of life.

The patient was an 83-year-old man. During a medical checkup, an abnormal chest shadow was noted, and bronchoscopy revealed a polypoid tumor in the bronchus of the right upper lobe. He was diagnosed with class IV adenoid cystic carcinoma by biopsy and referred to our department. At the time of surgery, there was a microscopically suspicious positive bronchial stump that was additionally resected for intraoperative rapid diagnosis, but it was difficult to perform additional proximal bronchial resection because the hilar lymph node was inflammatory and adherent to the main trunk of the right pulmonary artery. Based on the overall judgment, the surgery was terminated with upper lobectomy, the patient was discharged from the hospital, and received a total of 50 Gy of radiotherapy. Postoperative follow-up CT showed no recurrence.