A Case of adenoid cystic carcinoma of the trachea stage IV with lung metastasis / Patricia Margarita A. Guadines.

Includes bibliographical references.

Abstract: This is a case of a 30 year old female diagnosed with Adenoid Cystic Carcinoma of the Trachea in 2014. She underwent wide excision of neck mass with tracheal resection. Patient was subsequently subjected to Intensity-Modulated Radiation Therapy for 23 cycles. She was in remission for 6 years until October 2020, patient experienced shortness of breath associated with difficulty of breathing. Chest radiograph was done which showed multiple varisized ovoid densities in both lungs consistent with metastatic process. Chest CT scan confirmed the diagnosis with findings of varying size of hypermetabolic parenchymal and pleural nodules and masses, some confluent and some lobulated margins scattered in both lungs. The trachea-bronchial tree is patent with no evidence of focal mass seen. CT guided biopsy of the lung was performed to confirm the diagnosis. Axitinib immunotherapy was started for 5 cycles, however was not tolerated due to body weakness and weight loss. She was then given an oral chemotherapy (Capecitabine) for 2 months. Surveillance PET CT scan was done and was noted to have interval significant increase in the number and size of the parenchymal and pleural nodules. The patient was referred to our institution where initiation of combination of Pemetrexed + Cisplatin was done and was continued for 4 cycles. To present the disease course of a 30-year-old female diagnosed with Adenoid Cystic Carcinoma of the trachea St.IV with Lung Metastasis. To discuss the diagnostic approach and management of the patient diagnosed with Adenoid Cystic Carcinoma of the trachea with Lung Metastasis.

Research - Department of Medicine