BACKGROUND Adenoid cystic carcinoma(ACC)occurs mainly in the head and neck.Tracheal ACC(TACC)is uncommon.Primary resection is recommended as the main treatment of choice,and radiotherapy is considered for residual dis...BACKGROUND Adenoid cystic carcinoma(ACC)occurs mainly in the head and neck.Tracheal ACC(TACC)is uncommon.Primary resection is recommended as the main treatment of choice,and radiotherapy is considered for residual disease in the postoperative setting.Definitive radiotherapy is an alternative approach to cure unresectable TACC.As the status of radiosensitivity in TACC is uncertain,the evidence for radiotherapy in unresectable TACC is not well established,especially in terms of the optimal dosage and its response evaluation.Herein,we report a case of locally advanced TACC.CASE SUMMARY A 49-year-old woman was diagnosed with TACC,which included a range of lesions arising in the upper trachea extending caudally 2 cm to 7 cm of the glottis.She was treated with definitive radiotherapy,given the low likelihood of complete resection of the disease.Due to the indolent growth and the propensity for infiltration along the airways,the scheduled radiation dose of 76 Gy in 38 fractions with 6-MV X-ray delivered by intensity-modulated radiotherapy was conducted to the primary tumor volume.After irradiation of 40 Gy,the patient’s dyspnea on exertion was dramatically relieved and bronchoscopy revealed that the previous large polypoid intra-luminal mass was significantly eliminated,with near-complete response.The patient completed two phases of scheduled radiotherapy,and acute reactions to treatment included subjective chest tightness and grade 2 esophagitis,managed medically.After 5 years of treatment,the patient is alive without recurrent disease,and there were no serious late radiation esophagus and lung damage,with only slight dysphagia without perforation and fistula.CONCLUSION Taken together,TACC is uncommon and the treatment of unresectable TACC is challenging.This case indicated that patients with unresectable TACC who rapidly respond to radiation may benefit from primary radical radiotherapy.Radiotherapy may be considered an effective alternative treatment modality.展开更多
<strong>Background: </strong>Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thor...<strong>Background: </strong>Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thoracic diseases.<strong> Objective: </strong>To explore the epidemiology, diagnosis, treatment and future development of tracheal adenoid cystic carcinoma (TACC). <strong>Methods:</strong> With asymptomatic invasion of the tracheal prominence, a case of tracheal adenoid cystic carcinoma with asymptomatic invasion of the tracheal prominence was reported. The clinical management process and surgical methods were introduced, and related literature was reviewed and summarized. <strong>Results: </strong>The patient was admitted due to tracheal augmentation mass for half a month. Chest CT at admission displayed the soft tissue density shadow behind the tracheal augmentation process. After the completion of other examinations, tracheal tumor resection and tracheal reconstruction were performed. Postoperative routine pathology exhibited that it was TACC and without inguinal lymph node metastasis. <strong>Conclusion:</strong> TACC is a low-grade tracheal tumor with low incidence, delayed clinical manifestations and lack of specificity as well. CT and bronchoscopy are helpful for the diagnosis of suspected patients. Meanwhile, radical surgical resection is the first choice of treatment. Adjuvant therapy can improve the therapeutic effect. Targeted immunotherapy is the developing direction of treatment.展开更多
Objective: Locally advanced thyroid carcinoma is relatively rare;extrathyroid extension, such as to the trachea, is one of the most important prognostic factors. Surgical resection is the mainstay of treatment, and ap...Objective: Locally advanced thyroid carcinoma is relatively rare;extrathyroid extension, such as to the trachea, is one of the most important prognostic factors. Surgical resection is the mainstay of treatment, and appropriate surgical planning is crucial for obtaining a reasonable prognosis and quality of life of the patients. Case Report: Herein, we report a case of advanced thyroid carcinoma involving the trachea. Total thyroidectomy and window resection of the trachea were performed. The tracheal defect was approximately 2.5 × 3.0 cm in size, extending from the first to the third tracheal cartilage, and was reconstructed with auricular cartilage and covered with the sternohyoid muscles of both sides in a single-stage surgical procedure. The tracheal stoma was closed 2 weeks after the surgery. There were no postoperative complications. Conclusion: This reconstruction of the relatively small defect of the trachea provided excellent functional and cosmetic results.展开更多
基金Supported by National Natural Science Foundation of China,No.81573024。
文摘BACKGROUND Adenoid cystic carcinoma(ACC)occurs mainly in the head and neck.Tracheal ACC(TACC)is uncommon.Primary resection is recommended as the main treatment of choice,and radiotherapy is considered for residual disease in the postoperative setting.Definitive radiotherapy is an alternative approach to cure unresectable TACC.As the status of radiosensitivity in TACC is uncertain,the evidence for radiotherapy in unresectable TACC is not well established,especially in terms of the optimal dosage and its response evaluation.Herein,we report a case of locally advanced TACC.CASE SUMMARY A 49-year-old woman was diagnosed with TACC,which included a range of lesions arising in the upper trachea extending caudally 2 cm to 7 cm of the glottis.She was treated with definitive radiotherapy,given the low likelihood of complete resection of the disease.Due to the indolent growth and the propensity for infiltration along the airways,the scheduled radiation dose of 76 Gy in 38 fractions with 6-MV X-ray delivered by intensity-modulated radiotherapy was conducted to the primary tumor volume.After irradiation of 40 Gy,the patient’s dyspnea on exertion was dramatically relieved and bronchoscopy revealed that the previous large polypoid intra-luminal mass was significantly eliminated,with near-complete response.The patient completed two phases of scheduled radiotherapy,and acute reactions to treatment included subjective chest tightness and grade 2 esophagitis,managed medically.After 5 years of treatment,the patient is alive without recurrent disease,and there were no serious late radiation esophagus and lung damage,with only slight dysphagia without perforation and fistula.CONCLUSION Taken together,TACC is uncommon and the treatment of unresectable TACC is challenging.This case indicated that patients with unresectable TACC who rapidly respond to radiation may benefit from primary radical radiotherapy.Radiotherapy may be considered an effective alternative treatment modality.
文摘<strong>Background: </strong>Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thoracic diseases.<strong> Objective: </strong>To explore the epidemiology, diagnosis, treatment and future development of tracheal adenoid cystic carcinoma (TACC). <strong>Methods:</strong> With asymptomatic invasion of the tracheal prominence, a case of tracheal adenoid cystic carcinoma with asymptomatic invasion of the tracheal prominence was reported. The clinical management process and surgical methods were introduced, and related literature was reviewed and summarized. <strong>Results: </strong>The patient was admitted due to tracheal augmentation mass for half a month. Chest CT at admission displayed the soft tissue density shadow behind the tracheal augmentation process. After the completion of other examinations, tracheal tumor resection and tracheal reconstruction were performed. Postoperative routine pathology exhibited that it was TACC and without inguinal lymph node metastasis. <strong>Conclusion:</strong> TACC is a low-grade tracheal tumor with low incidence, delayed clinical manifestations and lack of specificity as well. CT and bronchoscopy are helpful for the diagnosis of suspected patients. Meanwhile, radical surgical resection is the first choice of treatment. Adjuvant therapy can improve the therapeutic effect. Targeted immunotherapy is the developing direction of treatment.
文摘Objective: Locally advanced thyroid carcinoma is relatively rare;extrathyroid extension, such as to the trachea, is one of the most important prognostic factors. Surgical resection is the mainstay of treatment, and appropriate surgical planning is crucial for obtaining a reasonable prognosis and quality of life of the patients. Case Report: Herein, we report a case of advanced thyroid carcinoma involving the trachea. Total thyroidectomy and window resection of the trachea were performed. The tracheal defect was approximately 2.5 × 3.0 cm in size, extending from the first to the third tracheal cartilage, and was reconstructed with auricular cartilage and covered with the sternohyoid muscles of both sides in a single-stage surgical procedure. The tracheal stoma was closed 2 weeks after the surgery. There were no postoperative complications. Conclusion: This reconstruction of the relatively small defect of the trachea provided excellent functional and cosmetic results.
