Clinical features, treatment, and prognosis of twelve cases of bronchial adenoid cystic carcinoma

Abstract

Objective To analyze the clinical features, treatment, and prognosis of 12 cases of bronchial adenoid cystic carcinoma. Methods We collected the clinical features and therapeutic regimens of 12 patients (11 females and 1 male, with the median age of 53.5 years), who were definitely diagnosed as bronchial adenoid cystic carcinoma and treated in the Respiratory Department in our hospital and carefully followed for their survival information from February 2012 to February 2018. A retrospective analysis was then performed with the clinical features, treatment, and prognosis information. Results All the 12 cases had no history of smoking, and 6 of them had no history of any illness. The main symptoms of all the 12 cases were cough, expectoration, and shortness of breath, and some of them had hemoptysis, chest pain or some other symptoms of respiratory system. In 8 cases, cancer arose from the middle-to-lower bronchial segments and in 2 cases, cancer arose from the upper segment of the main trachea (one from the right middle segment of the bronchus and the other one from the left main bronchus). Chest computed tomography (CT) was performed as a reference for primary diagnosis. In the 12 cases, nodules or masses were mainly shown on CT images, and calcification or granulation could also be observed in the tomography images of some cases. Under a bronchoscope, the tumor tissues were manifested as cauliflower-like, nodule-like, granulation-like, globe-like or other-shaped neoplasms. Borg index reached GradeⅡ in 5 cases, Grade Ⅲ in 3 cases, and Grade Ⅳ in 4 cases. Pneumonectomy was performed in the right lungs in one case and the other 11 cases accepted more than two kinds of bronchoscopic interventional therapies. The remission rate at level 1, clinical efficacy, and clinical benefit rate were all calculated as 100%. No baseline or recurrent metastasis was found in 3 cases, and in the other 9 cases, the carcinomas mainly metastasized to the lungs and bones. The survival time of 12 cases was all longer than 5 months. Conclusion Bronchial adenoid cystic carcinoma is a kind of low-grade malignant tumor, which mainly arises from the middle-to-lower bronchial segments. And the bronchial adenoid cystic carcinoma commonly metastasizes to the lungs and bones. The patients with bronchial adenoid cystic carcinoma are most likely to manifest as shortness of breath. Bronchoscopy can be used to define the extent of disease and obstructive degrees. Interventional therapy under a bronchoscope is an effective option, which can prognose a longer lifetime for nonoperative patients. Key words: Bronchial adenoid cystic carcinoma; Clinical features; Treatment; Prognosis