Abstract
We have successfully treated a case of adenoid cystic carcinoma arising from the cervical trachea by two-stage laryngeal preservation surgery followed by radiotherapy. A 39-year-old woman was diagnosed with dyspnea. Laryngoscopy revealed a tumor posterior to the right tracheal wall. A biopsy and tracheostomy were performed, and a histological evaluation of the tumor showed it to be adenoid cystic carcinoma (ACC). A two-stage surgical approach was designed to resect the tumor and reconstruct the trachea. We removed the tumor posterior to the right tracheal wall and inserted the cervical local flap at the defect to make a tracheo-cutaneous fistula. Three months after the ablation surgery, the defect of the trachea was reconstructed utilizing a hinge flap and anterior chest skin flap. Since the margin of the specimen was microscopically positive for cancer, postoperative radiotherapy was performed. Seven years after the treatment, the woman is surviving and shows no clinical sign of local recurrence and distant metastasis of the tumor. The experience of this case would indicate that our treatment strategy procedure seems to be the method of choice in cases with ACC of cervical trachea.
