A Case of Adenoid Cystic Carcinoma of the Trachea with a Solitary Lung Metastasis

Abstract

Background. Adenoid cystic carcinoma is relatively rare. The origin in most cases is the trachea and main bronchus. This carcinoma is considered to be slow-growing, compared with typical adenocarcinoma. Case. An 82-year-old woman complaining of dyspnea underwent flexible bronchoscopy at another hospital. She was found to have a tracheal tumor with an easy bleeding tendency just below the vocal folds. She was therefore referred to our hospital for the definitive diagnosis and treatment. Chest computed tomography showed a 1.3 cm tumor in the upper trachea and a 2.6 cm pulmonary nodule in the right S³. She underwent tracheal tumor resection with rigid bronchoscopy and a biopsy of the pulmonary lesion with flexible bronchoscopy at the same time. The histopathological findings showed adenoid cystic carcinoma of both lesions. Epidemiologically, 90% of adenoid cystic carcinomas originate in the central bronchi rather than the segmental bronchi. We therefore diagnosed this case as one with a tracheal origin and lung metastasis. Radiation therapy (40 Gy) was performed for the post-resection tracheal lesion. One month after radiation therapy, she underwent right upper lobectomy with video-assisted thoracic surgery. She has remained free from recurrence for one year since the surgery. Conclusion. We encountered a rare case of tracheal adenoid cystic carcinoma with a solitary lung metastasis at the first visit.