0
Allergy and Airway |

Adenoid Cystic Carcinoma (Cylindroma) of the Trachea

Emile Klada*, MD; Ruchi Bansal, MD; Juan George, MD; Lavanya Irugulapati, MD; Thomas Russi, MD
Author and Funding Information

New York Methodist, Brooklyn, NY


Chest. 2012;142(4_MeetingAbstracts):6A. doi:10.1378/chest.1388580
Text Size: A A A
Published online

Abstract

SESSION TYPE: Airway Case Report Posters

PRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PM

INTRODUCTION: Adenoid Cystic Carcinoma (ACC), also known as cylindroma, is a rare primary tracheal tumor, which comprises 0.1 - 0.2% of all lung cancers (1). Histologically, the majority of the tracheal tumors are squamous cell carcinomas, but ACC and mucoepidermoid carcinoma are seen in rare instances. We report a unique case of an elderly woman with wheezing who was found to have ACC.

CASE PRESENTATION: 88 year old female, former smoker with history of COPD, CHF and atrial fibrillation presented with shortness of breath and cough for 4 weeks .Physical examination was notable for labored breathing and bilateral wheezing. Patient was treated initially for a COPD exacerbation with intravenous steroid and nebulizers without improvement. Chest x-ray showed a right mid lung density and CAT scan of the chest showed a nodular 2.4 cm mass protruding into the trachea and a 4 cm solid opacity in the right mid-lung. Patient underwent flexible bronchoscopy and was found to have large endotracheal mass. Fine needle aspiration cytology revealed neoplasm of minor salivary gland, favoring ACC. The mass subsequently was removed via rigid bronchoscopy and the patient was discharged home .

DISCUSSION: ACC is the 2nd most common primary tracheal neoplasm. It usually arises in the proximal one-third or distal one-third of the trachea and has no association with tobacco exposure (2). ACC has a slow growing and prolonged clinical course; it is considered to be a low-grade malignancy and identical to ACC of the salivary glands (3). Most ACCs are discovered in middle age with no gender predilection .The common presenting symptoms of cough, dyspnea, hoarseness and wheezing are usually related to the size and location of the mass (3). Surgery is the standard treatment of tracheal tumors if possible and the rate of recurrence after resection is high. The tumor is relatively radiosensitive and post-operative radiotherapy may have some effect on local control but treatment does not affect overall survival rate.

CONCLUSIONS: Our patient demonstrates a rare case of ACC (cylindroma) of the trachea that was initially mis-diagnosed and treated for COPD exacerbations. Physicians should be aware of ACC of the trachea as a rare cause of persistent airway obstruction.

1) Ahn Y, Chang H, Lim YS, et al. Primary tracheal tumors: review of 37 cases. J Thorac Oncol 2009; 4:635

2) Maziak DE, Todd TR, Keshavjee SH, et al. Adenoid cystic carcinoma of the airway: thirty-two-year experience. J Thorac Cardiovasc Surg 1996; 112:1522

3) Webb BD, Walsh GL, Roberts DB, Sturgis EM. Primary tracheal malignant neoplasms: the University of Texas MD Anderson Cancer Center experience. J Am Coll Surg 2006; 202:237

DISCLOSURE: The following authors have nothing to disclose: Emile Klada, Ruchi Bansal, Juan George, Lavanya Irugulapati, Thomas Russi

No Product/Research Disclosure Information

New York Methodist, Brooklyn, NY

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543