ADENOID CYSTIC CARCINOMA PRESENTING LATE WITH INTRAPERICARDIAL EXTENSION

Abstract

TYPE: Case Report Publication TOPIC: Lung Cancer INTRODUCTION: Adenoid Cystic Carcinoma (ACC), a subtype of adenocarcinoma of the lung, is scarcely understood due to a global dearth of literature and number of cases. This salivary gland type malignant neoplasm accounts for 0.04-0.20% of all primary lung tumors, with airways being the most common site of occurrence. Moreover, this specific report also highlights its extension to the left atrium, a phenomenon that has hardly ever been documented in literature. CASE PRESENTATION: A 33-year-old male with no underlying comorbidities presented with hemoptysis since the past few days and chest pain for four years preceding that. He also had a history of successfully treated TB seven years ago. Based on the triad of clinical presentation, CT scan and transbronchial biopsy, a working diagnosis of ACC was made. Soon after, right posterolateral thoracotomy and right pneumonectomy with partial resection of the left atrium was performed. Histopathology analysis of the excised tissue revealed the tumor to be 4.5x3.5x3 cm in size but non-invasive (T2b), with no nodal involvement or metastasis. DISCUSSION: More commonly found elsewhere in the body (for example breast, skin and uterine cervix), ACC in the lung is commonly misdiagnosed as asthma or bronchitis. Literature suggests that surgical resection is the mainstay of treatment due to limitations with both radiotherapy and chemotherapy. Furthermore, one- and three-year survival rates have been documented at 71.8% and 37.8% respectively. CONCLUSIONS: This report aims to shed light on the unusual clinical pathophysiology, to register its atypical extensions and to navigate surgeons who may encounter this manifestation in the future. DISCLOSURE: No significant relationships. KEYWORDS: Neoplasm, Atypical, Cardiothoracic