Adenoid Cystic Carcinoma of the Bronchus: A Salivary Gland Tumor in the Airway

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Chest

Abstract

INTRODUCTION: Adenoid cystic carcinoma is primarily a malignancy of salivary glands with rare occurrence in the lower respiratory tract, accounting for 0.1% of all bronchopulmonary neoplasms. Here, we present a case of adenoid cystic carcinoma in a patient who presented with wheezing. CASE PRESENTATION: A 55-year-old female with no significant prior history presented to her primary care physician's office for intermittent shortness of breath and wheeze of one year duration. She was a never smoker. She underwent cardiac workup including Computed Tomography Coronary Angiography study, which revealed a filling defect in right mainstem bronchus (Figure 1).She was referred to pulmonology and underwent a bronchoscopy which revealed an irregular, protruding, round and papillomatous mass with irregular margins in the bronchus intermedius with greater than 75% obstruction (Figure 2). Endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) was done noting an avascular solid structure. During airway inspection after EBUS TBNA when attempting to traverse the lesion, part of the lesion was displaced and was able to be removed (Figure 3). EBUS needle sampling allowed for the mass to be transected enough so that it was removable after additional pressure was applied when traversing the lesion. Tissue pathology resulted positive for adenoid cystic carcinoma. Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) scan did demonstrate minimal FDG uptake in the lesion but no FDG avid nodal or distant metastatic disease. Patient has been referred to Oncology and Thoracic Surgery for further management. DISCUSSION: Adenoid cystic carcinoma of the airway is an extremely rare malignancy. Patients may present with shortness of breath, stridor or wheezing and recurrent infections. Management is mostly surgical with sleeve resection of airway with end to end anastomosis. Having negative margins gives a better prognosis, but radiation is still recommended. Placing an airway stent may help with airway stenosis in the short term but may lead to granulation tissue formation and potentially more stenosis in the long term. CONCLUSIONS: Adenoid cystic carcinoma of the airway originates from the submucosal glands of tracheobronchial tree. It is a slow growing tumor that recurs locally with mostly locoregional metastasis. Management of adenoid cystic carcinoma of the airway can involve surgical resection with radiotherapy.

Volume

168

Issue

4S

First Page

5104A

Last Page

5104A

Comments

American College of Chest Physicians CHEST Annual Meeting, October 19-22, 2025, Chicago, IL

DOI

10.1016/j.chest.2025.07.2863

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