Tracheal adenoid cystic carcinoma mimicking a thyroid tumor: A case report

Kukwa,Wojciech; Korzeń,Piotr; Wojtowicz,Piotr; Sobczyk,Grzegorz; Kiprian,Dorota; Kawecki,Andrzej; Kukwa,Andrzej; Krzeski,Antoni; Szczylik,Cezary; Czarnecka,Anna  M.

doi:10.3892/ol.2014.2282

Tracheal adenoid cystic carcinoma mimicking a thyroid tumor: A case report

Authors:
- Wojciech Kukwa
- Piotr Korzeń
- Piotr Wojtowicz
- Grzegorz Sobczyk
- Dorota Kiprian
- Andrzej Kawecki
- Andrzej Kukwa
- Antoni Krzeski
- Cezary Szczylik
- Anna M. Czarnecka
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Affiliations: Department of Otolaryngology, Czerniakowski Hospital, Medical University of Warsaw, Warsaw 00‑739, Poland, Department of Oncology, Military Institute of Medicine, Warsaw 04‑141, Poland, The Maria Sklodowska Curie Memorial Cancer Centre and Institute of Oncology, Warsaw 02‑781, Poland, Department of Otolaryngology and Head and Neck Disease, University of Varmia and Masuria School of Medicine, Olsztyn 10‑561, Poland
Published online on: June 25, 2014 https://doi.org/10.3892/ol.2014.2282
Pages: 1312-1316

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Abstract

At present, only eight cases of tracheal adenoid cystic carcinomas (ACCs) mimicking thyroid tumors have been reported. Since there are no guidelines available regarding their diagnosis and treatment, they present a significant clinical challenge. In the present study, patient treatment was analyzed to deliver the first concise summary of treatment options in patients with ACC mimicking a thyroid tumor. In addition, all available data regarding molecular abnormalities of this disease have been discussed. The current study presents a case of a 17‑year‑old patient with a tracheal ACC mimicking a thyroid tumor. The patient was diagnosed in 2007 with a pathological mass between the left lobe of the thyroid and the trachea, and underwent surgery and radiotherapy. In 2010, multiple lesions in the lungs were diagnosed and pulmonary metastasectomy was performed. Following surgery, the patient has been disease‑free for almost 30 months. Thyroid tumor biopsy may reveal ACCs. This pathological report requires further investigation of the head and neck in order to confirm if the disease is of tracheal origin. Patients may present with a neck swelling, hoarseness of voice or dysphagia. Surgery must be considered as first‑line therapy for all patients with local disease as it may be curative. For palliative treatment chemoradiotherapy based on cisplatin may be effective. The identification of cytogenetics, tumor suppressor genes, oncogenes, epigenetic alterations and mitochondrial abnormalities specific for ACCs is critical to the development of targeted therapies. Thus far, large studies have only reported the transcriptional activator Myb and mammalian target of rapamycin signaling pathway to be disrupted in ACCs.

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1	Gaissert HA and Mark EJ: Tracheobronchial gland tumors. Cancer Control. 13:286–294. 2006.
2	Delbouck C, Roper N, Aubert C, Souchay C, Choufani G and Hassid S: Unusual presentation of adenoid cystic carcinoma of the maxillary antrum. B-ENT. 5:265–268. 2009.
3	Park I, Lim SN, Yoon DH, et al: Metastasectomy for hepatic metastases from adenoid cystic carcinoma of the trachea. Gut Liver. 3:127–129. 2009.
4	Takahashi H, Kubota M, Nakata T, Nagai I, Kimura S and Noguchi S: A case of pulmonary metastasis from adenoid cystic carcinoma of the trachea. Nihon Kyobu Geka Gakkai Zasshi. 38:1063–1067. 1990.(In Japanese).
5	Bruzgielewicz A, Osuch-Wójcikiewicz E, Majszyk D, et al: Adenoid cystic carcinoma of the head and neck - a 10 years experience. Otolaryngol Pol. 65(Suppl 5): 6–11. 2011.(In Polish).
6	Selcuk A, Dere H, Bahar S, Sarikaya Y and Ozcan M: Adenoid cystic carcinoma of the parotid gland presenting as temporal bone neoplasm: a case report. B-ENT. 3:153–156. 2007.
7	Nuwal P, Dixit R and Singhal AK: Primary adenoid cystic carcinoma of trachea presenting as midline neck swelling and mimicking thyroid tumor: A case report and review of literature. Lung India. 27:167–169. 2010.
8	Yang PY, Liu MS, Chen CH, Lin CM and Tsao TC: Adenoid cystic carcinoma of the trachea: a report of seven cases and literature review. Chang Gung Med J. 28:357–363. 2005.
9	Bell D and Hanna EY: Head and neck adenoid cystic carcinoma: what is new in biological markers and treatment? Curr Opin Otolaryngol Head Neck Surg. 21:124–129. 2013.
10	Tsubochi H, Suzuki T, Suzuki S, et al: Immunohistochemical study of basaloid squamous cell carcinoma, adenoid cystic and mucoepidermoid carcinoma in the upper aerodigestive tract. Anticancer Res. 20:1205–1211. 2000.
11	Aslan DL, Oprea GM, Jagush SM, et al: c-kit expression in adenoid cystic carcinoma does not have an impact on local or distant tumor recurrence. Head Neck. 27:1028–1034. 2005.
12	Kuhel WI, Chow H, Godwin TA, Minick CR and Libby DM: Elevated carcinoembryonic antigen levels correlating with disease recurrence in a patient with adenoid cystic carcinoma. Head Neck. 17:431–436. 1995.
13	Tamura S, Yamaguchi K, Terada M, et al: Immunohistochemical analysis of CA19–9, SLX, and CA125 in adenoid cystic carcinoma of trachea and bronchus. Nihon Kyobu Shikkan Gakkai Zasshi. 30:407–411. 1992.(In Japanese).
14	Lin CM, Li AF, Wu LH, Wu YC, Lin FC and Wang LS: Adenoid cystic carcinoma of the trachea and bronchus - a clinicopathologic study with DNA flow cytometric analysis and oncogene expression. Eur J Cardiothorac Surg. 22:621–625. 2002.
15	Carlinfante G, Lazzaretti M, Ferrari S, Bianchi B and Crafa P: P53, bcl-2 and Ki-67 expression in adenoid cystic carcinoma of the palate. A clinico-pathologic study of 21 cases with long-term follow-up. Pathol Res Pract. 200:791–799. 2005.
16	Shimoda M, Sugiura T, Imajyo I, et al: The T-box transcription factor Brachyury regulates epithelial-mesenchymal transition in association with cancer stem-like cells in adenoid cystic carcinoma cells. BMC Cancer. 12:3772012.
17	Ishida M and Okabe H: Dedifferentiated adenoid cystic carcinoma of the trachea: a case report with respect to the immunohistochemical analyses of mammalian target of rapamycin pathway proteins. Hum Pathol. 44:1700–1703. 2013.
18	Porta C, Szczylik C and Escudier B: Combination or sequencing strategies to improve the outcome of metastatic renal cell carcinoma patients: a critical review. Crit Rev Oncol Hematol. 82:323–337. 2012.
19	Bellmunt J, Eisen T, Szczylik C, Mulders P and Porta C: A new patient-focused approach to the treatment of metastatic renal cell carcinoma: establishing customized treatment options. BJU Int. 107:1190–1199. 2011.
20	Suzuki T: What is the best management strategy for adenoid cystic carcinoma of the trachea? Ann Thorac Cardiovasc Surg. 17:535–538. 2011.
21	Li W, Hua W, Yan FG, Shen HH and Xu H: Adenoid cystic carcinoma of trachea: a case report and review of literature. Chin Med J (Engl). 125:2238–2239. 2012.
22	Refaely Y and Weissberg D: Surgical management of tracheal tumors. Ann Thorac Surg. 64:1429–1432; discussion 1432–1423. 1997.
23	Macchiarini P: Primary tracheal tumours. Lancet Oncol. 7:83–91. 2006.
24	Prommegger R and Salzer GM: Long-term results of surgery for adenoid cystic carcinoma of the trachea and bronchi. Eur J Surg Oncol. 24:440–444. 1998.
25	Allen AM, Rabin MS, Reilly JJ and Mentzer SJ: Unresectable adenoid cystic carcinoma of the trachea treated with chemoradiation. J Clin Oncol. 25:5521–5523. 2007.
26	Bonner Millar LP, Stripp D, Cooper JD, Both S, James P and Rengan R: Definitive radiotherapy for unresected adenoid cystic carcinoma of the trachea. Chest. 141:1323–1326. 2012.
27	Haresh KP, Prabhakar R, Rath GK, Sharma DN, Julka PK and Subramani V: Adenoid cystic carcinoma of the trachea treated with PET-CT based intensity modulated radiotherapy. J Thorac Oncol. 3:793–795. 2008.
28	Azar T, Abdul-Karim FW and Tucker HM: Adenoid cystic carcinoma of the trachea. Laryngoscope. 108:1297–1300. 1998.
29	Chang CY, Cheng SL and Chang SC: Adenoid cystic carcinoma of trachea treated with tumor curettage and adjuvant intensity modulated radiation therapy. South Med J. 104:68–70. 2011.
30	Shadmehr MB, Farzanegan R, Graili P, et al: Primary major airway tumors; management and results. Eur J Cardiothorac Surg. 39:749–754. 2011.
31	Liu D, Labow DM, Dang N, et al: Pulmonary metastasectomy for head and neck cancers. Ann Surg Oncol. 6:572–578. 1999.