Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Otolaryngology
Volume 2015, Article ID 404586, 4 pages
http://dx.doi.org/10.1155/2015/404586
Case Report

Laryngeal Preservation in Managing Advanced Tracheal Adenoid Cystic Carcinoma

1Department of Otolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland
2Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland

Received 18 January 2015; Revised 12 March 2015; Accepted 15 March 2015

Academic Editor: Manish Gupta

Copyright © 2015 Thavakumar Subramaniam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally.