A Case of Tracheal Adenoid Cystic Carcinoma with Severe Airway Stenosis due to Granulation after Stent Placement

Tada Kazuhiro, Koyama Akemi, Kitajima Ryo, Koyama Kenya

doi:10.2468/jbes.75.29

<p>Here we report a case of tracheal adenoid cystic carcinoma with severe airway stenosis due to airway granulation, without physical stimulation by the stent after endobronchial stenting for adenoid cystic carcinoma. The patient was a 43-year-old woman. In March two years prior to her first visit, she noticed pharyngeal discomfort, followed by persistent cough and dyspnea, and she was referred to our department for further testing and treatment in April of the following year. Plain chest computed tomography (CT) showed thickening of the tracheal wall and a mass protruding into the right side of the tracheal lumen, and positron emission tomography-CT showed uptake in the right side of the trachea. Endobronchial biopsy revealed severe stenosis of the tracheal lumen, so an Ultraflex-covered stent was placed in the protruding mass. Primary adenoid cystic carcinoma of the trachea was diagnosed by pathological examination. Intensity-modulated radiation therapy (66 Gy) was performed and progress was monitored. After about 1 year, the patient's cough had worsened and CT showed worsening airway stenosis caudal to the stent. As the stenosis was severe, the patient was intubated and placed on a ventilator. She was later extubated under extracorporeal membrane oxygenation and two additional Ultraflex-covered tracheal stents were placed cranial and caudal to the existing stent. Biopsy of the area at that same time showed inflammatory granulation tissue but no malignant cells.</p>

A Case of Tracheal Adenoid Cystic Carcinoma with Severe Airway Stenosis due to Granulation after Stent Placement

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