ADENOID CYSTIC CARCINOMA OF THE TRACHEA: A REPORT OF TWO CASES AND LITERATURE REVIEW

Adenoid cystic carcinoma (ACC) is a rare neoplasm, with an estimated incidence ranging from 0.1 to 0.26 per 100,000 individuals. It constitutes the second most prevalent primary malignant tumor of the trachea. Therapeutic bronchoscopy plays a vital role in enhancing the clinical condition of the patient prior to surgical intervention, which remains the primary treatment modality. Conversely, radiotherapy has demonstrated efficacy, in contrast to conventional chemotherapy. This malignancy tends to exhibit slow progression but is frequently fatal in the absence of radical treatment. We present a novel case of adenoid cystic carcinoma in a 71-year-old female patient, identified during an episode of tracheal wheezing accompanied by dyspnea that had persisted for one year. Diagnosis was established through biopsy of the tumor located in the lateral wall of the trachea via mediastinoscopy. The second case features a 55-year-old male, a former smoker with a history of progressive dyspnea over five years, productive cough with intermittent blood streaks, wheezing, and chest tightness. Chest CT revealed a nearly stenosing intratracheal mass. Bronchoscopy confirmed a tumor obstructing the trachea by 90%. Biopsy indicated ACC. Mechanical debulking and placement of a silicone Y-stent were performed, followed by successful endoscopic follow-up. The patient was classified as T4N3M0 and referred for chemoradiotherapy.