A Case of Adenoid Cystic Carcinoma in the Trachea Complaining of Dysphagia

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  • Ueda Masaru
    Department of Otolaryngology, Ayabe Municipal Hospital
  • Nakano Hiroshi
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Ikebuchi Kaichiro
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Matsui Masahiro
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Shimada Taketoshi
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Shinomiya Takashi
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Nakai Shigeru
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Hisa Yasuo
    Department of Otolaryngology, Head and Neck Surgery, Kyoto Prefectural University of Medicine

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Other Title
  • えん下困難を初発症状とした気管膜様部腺様嚢胞癌の１例
  • 症例報告 嚥下困難を初発症状とした気管膜様部腺様嚢胞癌の1例
  • ショウレイホウコク エンゲ コンナン オ ショハツ ショウジョウ ト シタ キカン マク ヨウブセン ヨウノウホウガン ノ 1レイ

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Abstract

Although adenoid cystic carcinomas comprise half of all tumors of the trachea, the incidence of tracheal tumors itself is low, and tumors of the trachea, the tracheal branches and lungs comprise less than 0.5% of all malignant tumors. We encountered a case of tracheal adenoid cystic carcinoma that was difficult to diagnose, and we accordingly report some additional documentation for consideration.<br>A 62-year-old male visited our hospital complaining of dysphagia. There were no abnormal findings in the ears, nose, pharynx, or neck, but his left vocal cord mobility was limited. A tumor surrounding the trachea and extending to the right lobe of the thyroid was revealed by computed tomography and magnetic resonance imaging. Our initial diagnosis was a benign tumor in the esophagus. We performed fine needle aspiration cytology under ultrasonography, and we made a diagnosis of class V adenocarcinoma. In thallium scintigraphy, a shadow indicating the tumor was found in the early phase and wash-out of the shadow was poor in the delayed phase. The thyroid function, intact PTH, and PSA were within the normal ranges. Accordingly, our preoperative diagnosis was thyroid follicular carcinoma. After preoperative irradiation, a total thyroidectomy and extraction of the tumor were performed. A diagnosis of adenoid cystic carcinoma was made based on examination of the surgical specimen. Although additional irradiation was performed, multiple bone metastasis and lung metastasis occurred, and the patient died. As we report here, adenoid cystic carcinoma of the trachea showing external growth as in this case is very difficult to diagnose.

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