A Case of Tracheal Adenoid Cystic Carcinoma in a Worker Exposed to Rubber Fumes

Dohyung Kim,Eun-A Kim,Sungyeul Choi,Chulyong Park,Yang-In Hwang,Naroo Lee

doi:10.1186/2052-4374-25-22

Abstract

BackgroundPrimary tracheal tumors occur infrequently, accounting for less than 0.1% of all tumors. Adenoid cystic carcinoma (ACC) is the second most common type of malignancy of the trachea after squamous cell carcinoma (SCC). Little has been reported on the risk factors for tracheal ACC. The purpose of this study is to describe a case of tracheal ACC in a patient who had been exposed to rubber fumes, and to review the relationship between tracheal ACC and rubber fumes.Case reportA 48-year-old man who had been experiencing aggravation of dyspnea for several months was diagnosed as having ACC of the trachea on the basis of a pathologic examination of a biopsy specimen obtained via laser microscopy-guided resection. The patient had been exposed to rubber fumes for 10 years at a tire manufacturing factory where he worked until ACC was diagnosed. His job involved preheating and changing rubber molds during the curing process.ConclusionACC of both the trachea and the salivary glands show very similar patterns with regard to histopathology and epidemiology and are therefore assumed to have a common etiology. Rubber manufacturing is an occupational risk factor for the development of salivary gland tumors. Further, rubber fumes have been reported to be mutagenic. The exposure level to rubber fumes during the curing process at the patient’s workplace was estimated to be close to or higher than British Occupational Exposure Limits. Therefore, tracheal ACC in this case might have been influenced by occupational exposure to rubber fumes.

Highlights

Primary tracheal tumors occur infrequently, accounting for less than 0.1% of all tumors
Tracheal Adenoid cystic carcinoma (ACC) in this case might have been influenced by occupational exposure to rubber fumes
The only risk factors that have been investigated with regard to tracheal ACC are age, sex, and smoking status

Summary

Conclusion

Tracheal ACC is known to originate from the salivary glands of the trachea [6]. it seems natural that tracheal ACC resembles salivary gland ACC of the head and neck (HNACC) in many ways. We presumed that the risk factors for head and neck salivary gland tumors and tracheal ACC are similar, which needs more thoughtful consideration. This study is the first case report that suggests a relationship between exposure to rubber fumes and the development of tracheal ACC. Exposure levels of rubber fumes for this case are estimated to have been close to or higher than the British OEL, but those of other potential carcinogens such as PAHs and N-nitrosamines are not. The patient was an ex-smoker, tracheal ACC is not known to be associated with a smoking habit This patient was not concluded to have been exposed to other risk factors of salivary gland tumors such as HIV infection or ionizing radiation. Consent Written informed consent was obtained from the patient’s guardian/parent/ of kin for the publication of this report and any accompanying images

Background

Findings

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