Subglottic adenoid cystic carcinoma mistaken for asthma

Abstract

Adenoid cystic carcinoma rarely occurs within the subglottic larynx. In this study, a case of subglottic adenoid cystic carcinoma was reported. A 54 year-old Chinese woman developed a sudden onset of chest distress and cough worsening after physical exertion, and was diagnosed with, and treated as, bronchial asthma. Regular anti-asthmatic therapy did not improve the symptoms. Until a sudden dyspnea, a cervicothoracic computerized tomography (CT) revealed that her upper airway was obstructed by a laryngeal tumor. The patient was diagnosed with a subglottic adenoid cystic carcinoma and treated with complete surgical excision and adjuvant radiation therapy. Follow-up endoscopy and laryngeal magnetic resonance imaging (MRI) at six months showed no recurrence of the tumor. The diagnosis of subglottic adenoid cystic carcinoma should be considered in patients who are characterized by dyspnea, cough, and stridor, but do not respond to regular anti-asthmatic therapy.

Adenoid cystic carcinoma of the larynx: A report of two cases

“…ACC of the larynx has been reported in other provinces in China, including Zhejiang (8) and Jiangsu (9), while to the best of our knowledge, there are no reports of this disease from Hainan province to date. In this study, the data of all patients histopathologically diagnosed with laryngeal carcinoma between January 1994 and 2014 at Hainan Province People's Hospital (Haikou, China) were retrospectively reviewed.…”

“…The optimum treatment regimes remain unclear. Previous case reports recommend different management strategies and there are few data on the long-term results of these approaches (8,12,13,19). There is not yet a standardized treatment for the management of patients with laryngeal ACC.…”

Tracheolaryngeal Adenoid Cystic Carcinoma: The tumour that almost took her breath away

“…2 As with the current case, ADCC can present with symptoms of obstruction, such as breathlessness. 3 The differential diagnosis for ADCC includes polymorphous low-grade adenocarcinomas, basal cell adenomas, mixed tumours and basaloid squamous cell carcinomas. 4 A cribriform pattern of tumour cells is typical of ADCC; however, this pattern is rarely seen in basal cell adenomas, basaloid squamous cell carcinomas and mixed tumours.…”

“…5 This is further compounded by the deceptively circumscribed macroscopic appearance of the tumours. 3 These factors are challenging for surgeons attempting to remove the tumour with negative margins. Due to inadequate surgical excision, recurrence rates are high, ranging from 75-90%.…”

“…6 Radical surgery has not been shown to improve survival rates or decrease local recurrence when compared with a conservative surgical approach and postoperative radiation. 3 Optimal treatment therefore remains wide local excision with or without postoperative radiation. …”