Objective To report a case of adenoid cystic carcinoma of the trachea admitted to the Second Hospital of Hebei Medical University who has achieved good outcomes after interventional flexible bronchoscopy combined with radiotherapy and chemotherapy.This study aims to increase the understanding of the adenoid cystic carcinomas of the trachea managed by interventional flexible bronchoscopy and chemotherapy outcomes.Methods CT and bronchoscopy confirmed an occupying lesion on the right-sided wall of the trachea.An adenoid cystic carcinoma of the trachea was finally diagnosed by interventional rigid and flexible bronchoscopy under general anesthesia.Endoscopic findings revealed a cauliflower-like neoplasm(2cm in length)on the wall of the lower trachea on the right side,the distal end of which was 1cm away from the carina.The neoplasm resulted in a 50%lumen blockage.It was resected using an electric snare,and the stump was frozen with carbon dioxide.Postoperative chemotherapy was performed in the local hospital.After four and a half years of surgery,the patient developed recurrence of airway neoplasms.CT scans suggested:(1)a soft mass in the main bronchus;(2)multiple patchy and nodular high-density and ground-glass shadows in the upper lobes of both lungs and the lower lobe of the left lung,with unclear borders and surrounding burrs,suggesting the possibility of tumor lesions;(3)multiple lymph nodes in the mediastinum,some of which were slightly enlarged.Bronchoscopy showed a spherical mass in the middle and lower segment of the trachea blocking 75%of the lumen.The base of the mass was widened at the membranous part,and the upper edge of the mass was 6cm away from the glottis.A flexible bronchoscope was inserted through the laryngeal mask,and the tumor was resected with a snare.The remaining tumor lesions were frozen.Argon plasma coagulation(APC)was performed for hemostasis.Postoperative chemotherapy regimen of albumin paclitaxel 200mg on day 1 and day 8 plus cisplatin 60mg on day 1-2 was applied.Results A longer recurrence-free survival was yielded after the initial cold snare resection,cryotherapy and radiotherapy.Tumor recurrence occurred four and a half years later.The recurrent tumor was significantly shrunk after tumor resection using the flexible bronchoscopy and two cycles of chemotherapy.The patient was in a good condition at present.Conclusion Interventional flexible bronchoscopy combined with radiotherapy and chemotherapy is featured by simple procedures,less damages and convivence for repeated treatment for patients with adenoid cystic carcinomas of the trachea.It yields acceptable outcomes and improves the survival,deserving a further promotion to patients who are contraindicative to surgeries.
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