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Metastases from tracheal adenoid cystic carcinoma
  1. Voon Shiong Ronnie Tan1,
  2. Andrew Li1,
  3. Ju Ee Seet2,
  4. Pyng Lee1
  1. 1 Respiratory and Critical Care Medicine, National University Hospital, Singapore
  2. 2 Pathology, National University Hospital, Singapore
  1. Correspondence to Dr Voon Shiong Ronnie Tan, Respiratory and Critical Care Medicine, National University Hospital, Singapore 119074, Singapore; ronnie_tan{at}

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A 32-year-old female never smoker presented with dyspnoea and stridor. CT thorax showed a polypoidal mass obstructing the trachea. Bronchoscopy revealed a circumferential nodular tumour 4 cm from the vocal cords, removed using electrosurgical snare and thereby re-establishing trachea patency (figure 1A,B). Histology showed adenoid cystic carcinoma (ACC). She underwent tracheal resection; as the resection margins showed ACC with perineural and fascia invasion, she received adjuvant radiation therapy 72 Gy. Yearly CT chest was performed for surveillance and CT 8 years after surgery showed enlarged subcarinal lymphadenopathy, bilateral pulmonary nodules and a left thyroid nodule (figure 1C,D). Thyroid ultrasound fine-needle aspiration confirmed 1 cm hypoechoic nodule due to ACC. Endobronchial ultrasound-guided transbronchial needle aspiration of subcarinal lymph node revealed metastatic ACC (figure 2), but no recurrence in the trachea.

Figure 1

(A) Malignant polypoidal tracheal tumour with 80% obstruction (B) CT coronal view showed polypoidal …

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  • Contributors All the authors are involved in the preparation of the manuscript and have approved the final version, taken due care to ensure its integrity.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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