Primary Tracheal Adenoid Cystic Carcinoma Research Articles

Proton Beam Therapy as a Curative Treatment for a Young Case of Unresectable Tracheal Adenoid Cystic Carcinoma.

Primary tracheal adenoid cystic carcinoma (TACC) is a rare malignancy without an established treatment. Central airway obstruction due to TACC often decreases the quality of life and has life-threatening consequences. A 19-year-old man with unresectable TACC and central airway obstruction suffered from progressive cough and dyspnea after exercise. Proton beam therapy (PBT) was selected as the preferred treatment over systemic anti-cancer chemotherapy for TACC. PBT led to complete remission of TACC and the almost complete disappearance of the respiratory symptoms without adverse events. PBT is a useful and safe treatment for unresectable primary TACC.

A surgical conundrum: Managing primary tracheal adenoid cystic carcinoma with preservation of larynx

Title: A surgical conundrum: managing primary tracheal adenoid cystic carcinoma with preservation of larynx. Introduction: Tracheal tumors are extremely uncommon. The incidence of tracheal tumors is 0.09–0.2% out of which 10% are Adenoid cystic carcinoma. The origin of adenoid cystic carcinoma is from the submucosal glands of the tracheal tree. It is typically regarded as a low-grade malignancy with a favorable prognosis. Case Presentation: A 35 years old male patient came to Out Patient Department with chief complaints of change in voice since 6 months and stridor since 1 week. On Indirect laryngoscopy there was left sided vocal cord palsy with submucosal swelling in subglottic area compromising the airway. Contrast Enhanced Computed Tomography revealed a hyperintense lesion of about 5.5 cm craniocaudally in the posterolateral aspect of the subglottic trachea and inferior border of the cricoid pushing left thyroid lobe anterolaterally along with significant obstruction of the airway at the level of cricoid. An emergency tracheostomy was done at lower level to secure the airway. Flexible bronchoscopy showed a 1.5-2cm stenotic segment obstructing 50 to 75% of the airway in a subglottic region with left vocal cord palsy. A biopsy of the lesion took externally which came as an Adenoid Cystic Carcinoma. On Magnetic Resonance Imaging there was no involvement of the nerve or metastasis. Wide local excision of the lesion involving tracheal resection with cricotracheal anastomosis and Montgomery Tube insertion was done followed by chemoradiation. Montgomery tube was successfully removed and the patient satisfactorily decannulated. Conclusion: Adenoid cystic carcinoma should be considered as a differential diagnosis in patients with changes in voice and stridor. As adenoid cystic carcinoma is very slow-growing tumor so instead of being so radical a combined approach that gives a functional larynx and better quality of life should opt.

Surgical Treatment of Primary Tracheal Adenoid Cystic Carcinoma.

Primary tracheal adenoid cystic carcinoma (TACC) occurring in the cervical trachea and invading the thyroid is very rare. Surgical resection and airway reconstruction are the main treatment methods, and other treatments include radiotherapy and endoscopic intervention. Herein, we present the case of a 74-year-old female patient with TACC. The patient underwent surgery and postoperative pathology showed that the tumor invaded the adventitia of the trachea and bilateral thyroid, where nerve involvement was observed. The patient recovered well after the operation without adjuvant therapy. Eight months after the operation, Computed tomography showed that the trachea was unobstructed and there was no recurrence.

Primary tracheal obstruction caused by adenoid cystic carcinoma during pregnancy: A case report

The incidence of malignant tumors diagnosed during pregnancy is increasing, often ascribed to the recently recognized trend that many women are postponing childbirth. Although early diagnosis is optimal for both mothers and fetuses, the diagnosis of malignant tumors during pregnancy is often delayed until an advanced stage, because generalized symptoms of pregnancy and malignancy may overlap, such as shortness of breath, chest or abdominal discomfort. The study patient was 21years old, and 31weeks-pregnant when she was diagnosed with primary tracheal adenoid cystic carcinoma (ACC). The patient initially presented with dyspnea and decreased blood oxygen saturation and underwent a cesarean section on the first night of hospitalization, resulting from fetal distress. This case report intended to investigate potential barriers to the timely diagnosis of tracheal ACC and consider optimal management strategies when it is diagnosed during pregnancy.

Continual Cough: Experience and Lessons from a Case of Bronchial Adenoid Cystic Carcinoma

Background: Primary tracheal adenoid cystic carcinoma is a rare, slow-growing pulmonary malignancy. Due to the low incidence, clinicians are poor in the diagnosis and treatment of such disease, which is prone to cause misdiagnosis or missed diagnosis, consequently leading to delayed treatment. Case Presentation: Here, we reported a case of a 72-year-old woman who was diagnosed as primary bronchial adenoid cystic carcinoma after three years. At the time of final diagnosis, lesion involvement was seen in the entire bronchus and radical treatment was not available. Conclusions: Endoscopic bronchoscopy and palliative radiotherapy can relieve the symptoms of the patient and make the patient survive with the tumor for a long time.

Efficacy of Neutron Radiotherapy for Primary Tracheal Adenoid Cystic Carcinoma: A Single Institution Retrospective Analysis

Background: Primary adenoid cystic carcinoma (ACC) is the second most common primary tracheal neoplasms but the data for optimal treatment plan is limited. This study is an update of our institutional experience treating primary ACC of the trachea with neutron radiotherapy.

A 10-year clinical outcome of radiotherapy as an adjuvant or definitive treatment for primary tracheal adenoid cystic carcinoma

BackgroundTo evaluate the role of radiotherapy (RT) as an adjuvant or definitive treatment in primary tracheal adenoid cystic carcinoma (ACC) for local tumor control and survival.MethodsA retrospective chart review was performed in 22 patients treated with adjuvant or definitive RT for primary tracheal ACC at a single center between November 1994 and December 2008.ResultsThirteen and 9 patients received adjuvant and definitive RT, respectively. Microscopic residual disease after surgery was pathologically reported in 11 patients. The median RT dose was 59.4 Gy for adjuvant and 74.4 Gy for definitive RT. The overall response rate for definitive RT was 77.8%. Six patients in the definitive RT group exhibited local progression (LP), whereas 14 patients in both groups exhibited distant metastasis. The most common recurrence site in cases of treatment failure was the lung parenchyma. The median follow-up duration was 123 months, and the 10-year overall survival (OS) rate was 54.2%. Although LP was the most common cause of death (4 patients), two-thirds of the patients treated with definitive RT lived for >5 years. The 5-year and 10-year LP-free survival (LPFS) rates in the definitive RT group were 66.7 and 26.7%, respectively. Patients with higher RT dose by brachytherapy boost had good 5-year OS, 83.3%, and showed no local progression till 5-years. Most of the RT-induced side-effects were mild and tolerable, but 2 patients died of tracheal stenosis without any tumor recurrence.ConclusionsAdjuvant RT may be suitable for controlling microscopic residual disease, whereas definitive RT may yield appropriate long-term survival in >50% patients with unresectable tracheal ACC. Dose escalation should be considered to warrant long-term survival in definitive RT.

Resected Tracheal Adenoid Cystic Carcinoma: Improvements in Outcome at a Single Institution

Primary tracheal cancer comprises a heterogeneous and rare group of neoplasms. Management of patients with primary tracheal carcinoma at our institution has improved in recent years. This retrospective review included patients with localized primary tracheal adenoid cystic carcinoma treated surgically at our institution between January 1995 and December 2014. Patients were classified according to the timing of first operation: "early years" operation was performed between January 1995 and December 2002, and subsequent "recent years" operation was associated with improved management and a focus on early diagnosis. The proportion of patients with tracheal malignancy who underwent operation for adenoid cystic carcinoma increased with time. Patients in the recent group were significantly younger than those in the early group at diagnosis (49.3 ± 7.8 years versus 45.7 ± 9.4 years; p = 0.042), and the resected tumor size and tracheal lengths tended to be smaller (28.2 ± 7.6 mm versus 30.3 ± 7.0 mm; p = 0.161) and shorter (32.1 ± 7.7 mm versus 34.4 ± 6.7 mm; p = 0.123). The use of postoperative radiotherapy in patients with R1 resection was also managed more effectively in the recent group compared with the early group (90.6% versus 65.0%; p = 0.009). Five- and 10-year overall survival rates in the early and recent groups were 86.4% and 90.8%, and 31.8% and 61.2%, respectively (p = 0.084), and the corresponding 5- and 10-year disease-free survival rates were 39.7% and 75.3%, and 9.9% and 21.2%, respectively (p = 0.025). There have been improved outcomes of adenoid cystic carcinomas. Early diagnosis, experienced surgical treatments, and postoperative adjuvant radiotherapy for patients with positive margins may contribute to the improved survival of patients with primary tracheal adenoid cystic carcinoma.

Laryngeal preservation in managing advanced tracheal adenoid cystic carcinoma.

A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally.

Primary tracheal adenoid cystic carcinoma: adjuvant treatment outcome.

Adenoid cystic carcinoma (ACC) is the second most common tracheal tumor, but its optimal treatment strategy is still controversial. To further elucidate the impact of treatment on disease-free survival (DFS) and overall survival (OS), we retrospectively investigated different treatment modalities and outcomes of 56 patients with primary ACC of the trachea treated at four hospitals in Sichuan Province of China from 1995 to 2012. 52 patients were included in the analysis. 4 patients with unresectable tumors were treated primarily with radiotherapy (RT) alone. 11 of 48 patients who received surgery as primary therapy obtained complete resection without adjuvant therapy. 24 of 37 patients who had incomplete resection (R1, R2) received postoperative RT while 13 patients were treated without postoperative RT. Postoperative chemotherapy (CT) was used in 12 patients with postoperative RT. No significant difference was shown in DFS (p = 0.683) and OS (p = 0.829) between patients with complete resection and those with incomplete resection. Postoperative RT for patients with incomplete resection was associated with improved DFS (92 vs. 62 months, p = 0.027) and OS (125 vs. 78 months, p = 0.004). Postoperative chemotherapy (CT) following RT did not have a significant impact on DFS (p = 0.390) or OS (p = 0.646) in patients with positive margin. These observations suggest that postoperative RT should probably be recommended for patients with incomplete resection. Postoperative CT following RT in patients with incomplete resection did not seem to produce an additional survival benefit.

Primary Tracheal Adenoid Cystic Carcinoma with Malignant Pleural Effusion

The name of the first author, Yasuo Masanori, should have been Masanori Yasuo. The authors and editors apologize for any confusion this may have caused.

Primary Tracheal Adenoid Cystic Carcinoma with Malignant Pleural Effusion

Primary Tracheal Adenoid Cystic Carcinoma with Malignant Pleural Effusion

気管ステント留置および術前放射線療法が奏功し気管管状切除術を施行しえた原発性気管癌の１例

症例は64歳女性.主訴は徐々に増強する呼吸困難感.胸部X-pおよびCT写真にて, 気管上部の圧排と気管の狭窄を認めた.気管支鏡検査では声門直下に頚部気管の膜様部左側から隆起する腫瘍を認め, 内腔は約90%狭窄していた.生検にて気管腺様嚢胞癌の診断を得た.気道確保のためにNd: YAGレーザーにて腫瘍を焼灼し, シリコン製のDumonステントを硬性気管支鏡下に留置した.腫瘍及び左鎖骨上窩リンパ節に計49.6Gyの術前放射線照射を行い, 効果はPRであった.その後, 頚部襟状切開下に第2気管軟骨輪から4軟骨輪を切除する気管管状切除術を施行した.術後反回神経麻痺を認めず, 発声機能が温存できた.術後16ヵ月目の現在, 局所再発や遠隔転移は認められない.

血清中 SLX, CA 19-9 高値を示した気管原発腺様嚢胞癌の 1 例

血清中 SLX, CA 19-9 高値を示した気管原発腺様嚢胞癌の 1 例

Primary tracheal and bronchial adenoid cystic Carcinoma (Cylindroma)

The subgroup bronchial gland carcinoma, constitutes approximately 1-2% of all lung tumors. Of these, 85% are carcinoid tumors, 10% adenoid tumors, 10% adenoid cystic carcinomas and 5% mucoepidermoid tumors (1,2)