THE PROGNOSIS AFTER SURGERY IN ADENOID CYSTIC CARCINOMA

Abstract

TYPE: Abstract Publication TOPIC: Lung Cancer PURPOSE: Tumors involving the carina represent a challenge due to the complexity of airway reconstruction and management. Adenoid cystic carcinoma (ACC) can be misdiagnosed as an obstructive lung disease, because the signs and symptoms are nonspecific. METHODS: A 40-years-old man, ex-smoker (30PY), with history of childhood asthma, presented with progressive shortness of breath and nonproductive cough in the last 6 months and hemoptysis in the last days before admission to our hospital. Despite chest X-ray was normal, HRCT scan revealed an intraluminal mass arising from the left main bronchus within 8 mm of the carina, in close contact with the esophagus. Fortunately, endoscopy didn't identify local infiltration. A flexible-bronchoscopy showed an irregular protruded mass that causing obstructed with 40% of the lumen of the proximal left main-stem bronchus. Histopathological exam of a bronchial biopsy - cribriform and pseudo-tubular patterns of ACC RESULTS: The tumor was considered resectable (T1cN0M0-IA3), a surgical resection of the complete mass with left main bronchus resection and reconstruction were done. Despite the adjuvant radio/chemotherapy, PET/CT scan and bone scintigraphy showed complications CONCLUSIONS: Early diagnosis of bronchus tumor is missing and thus lead to a delay in the treatment. Prognosis depends on staging, histological pattern (solid pattern having the worst prognosis and tubular having the best prognosis) and complete resection. CLINICAL IMPLICATIONS: Surgical resection followed by radiotherapy is widely recommended protocol for treatment of this localized tumors and provides the best chance of pronlonged survival. DISCLOSURE: No significant relationships. KEYWORDS: Bronchial tumor, long-term survival., Complications