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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. 1Respiratory and Critical Care Medicine, National University Hospital, Singapore
  2. 2Pathology, 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}nuhs.edu.sg

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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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Footnotes

  • 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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