[Tracheobronchial adenoid cystic carcinoma: seven case reports]

Adenoid cystic carcinoma of the respiratory tract is a rare form of malignant neoplasm that arises from salivary glands. A surgical resection with or without radiotherapy is commonly recommended. For inoperable patients, radiotherapy and endobronchial treatment, which include laser and stent insertion, are important therapeutic modalities.

To summarize our experience in adenocystic carcinoma of the respiratory tract.

Seven patients with adenoid cystic carcinoma were diagnosed and treated in the Pulmonary Institute at Rabin Medical Center, a tertiary care hospital in central Israel in 2000-2006.

Three patients were men and four were women, with a presenting age at diagnosis ranging from 31 to 79 years. All the patients were nonsmokers. Major symptoms at presentation included dry cough, dyspnea and hemoptysis. Only two patients were operable at time of presentation and 4 patients had local and distant metastases. In 6 patients the tumor was presented in the trachea with marked obstruction of the tracheal lumen. In 4 patients coexisting lesions in the main bronchus were also found. Two patients with non-metastatic disease underwent surgical resection with external radiation. Multiple laser therapy and brachytherapy were performed in 4 patients. Two patients with severe airway stenosis that was resistant to radiotherapy were treated with laser and intratracheal stent replacement.

Endobronchial therapy that includes brachytherapy, laser and stent insertion, is a useful therapeutic modality for the treatment of patients with adenoid cystic carcinoma of the respiratory tract who are resistant to radiotherapy.