Primary adenoid cystic carcinoma of the lung: A case report and literature review

Abstract

Primary adenoid cystic carcinoma (ACC) of the lung is an unusual thoracic neoplasm with slow growing and low-grade malignancy. Usually, it is diagnosed at a higher clinical stage and is difficult to resect due to its central location. Herein, we report a 56-year-old man with hemoptysis associated with dyspnea and weight loss lasting for one month. Bronchial fibroscopy highlighted a budding nodular tumor in the left main bronchus. The patient underwent a left pneumonectomy with mediastinal lymphadenomectomy. Microscopic examination showed tumor cells infiltrating the bronchial wall and the cartilage and concluded to an ACC of the left bronchus. Ear, nose, and throat examination as well as cervico-facial magnetic resonance imaging were performed to search a primary salivary gland tumor and were returned without abnormalities. The tumor was classified as a primary ACC of the left bronchus without lymph node metastasis. To avoid their misdiagnosis, ACCs of the lung should be well known by the pathologist and surgeons. Their pathological features may be misleading and referring to a benign lesion, however, the presence of cribriform foci and infiltrative pattern are very suggestive. Although, indolent and slow growing tumor, long-term recurrences are quite frequent, especially in case of unclear surgical margin.

Rare Case of Primary Adenoid Cystic Carcinoma of the Lung With Bilateral Kidney and Liver Metastasis

“…Unfortunately, in our case this gene was not able to be assessed. Additionally, recent case studies have found that ACC of the lungs may show partial response to targeted therapies such as imatinib due to the expression of c-KIT [ 2 ]. Further studies should be done to determine efficacy of these targeted therapies.…”

“…Notably, it may also arise in the breast, digestive tract or lungs. Instances in which ACC is classified as a primary lung tumor are rare, accounting for only 0.04-0.2% of all primary lung tumors [ 2 ]. Previously, primary ACC of the lungs was referred to as a benign glandular neoplasm.…”

Multiple primary lung cancer comprised of adenocarcinoma and adenoid cystic carcinoma: a case report

“…The present case was composed of an adenocarcinoma and ACC, which is rarely reported. A rare type of tumor, ACC of the lung accounts for 0.04-0.2% of primary pulmonary tumors (7). It commonly involves the salivary glands in the head and neck (8).…”

A rare case of pulmonary adenoid cystic carcinoma with liver metastases treated effectively with stereotactic body radiation therapy

“…3 PACC constitutes about 0.04%-0.2% of all primary pulmonary tumors. 4 Because PACC grows slowly and has a long clinical course, it is classified as a low-grade malignancy. In a study by Takanori K et al, the median age at presentation was 46 years.…”

“…Therefore, in patients with PACC occurring in the lung periphery, it is paramount to rule out lung metastasis from a primary salivary gland tumor. 4 The exact etiology of PACC remains unknown. Fortunately, current research has shown the presence of consistent genetic mutations in the variety of ACC tumors irrespective of the tumor location.…”