Primary adenoid cystic carcinoma in the lung: reporting a recurrent case at an advanced stage and mini-literature review.

Abstract

Abstract Introduction: Primary adenoid cystic carcinoma (ACC) of the lung only account for less than 0.2% of all primary lung tumors. ACC in lung usually arises from the peribronchial glands and they are usually proximally located which makes it often challenging for surgical resection Case presentation: A 65-year-old woman who was diagnosed with adenoid cystic carcinoma in 2017 at another institution and treated with lobectomy. In 2021, she presented at our hospital with frequent cough and dyspnea at rest and on exertion. Chest radiography showed bronchial obstruction and lung atelectasis, for stent placement for symptomatic relief. Repeated chest CT in 2022 showed progression of the tumor involving beyond the lung parenchyma into pleura and diaphragm Finally, the patient had left posterolateral thoracotomy, extra pleural pneumonectomy, En bloc pericardiectomy and En bloc resection of left diaphragm. Now she is on lung cancer surveillance with chest CT every 6 months. Last chest CT did not show any residual tumor or recurrence. Conclusion: Despite its rarity, primary ACC of the lung should be well recognized by the pathologist and clinicians to make accurate diagnosis. . Although ACC of the lung usually has an indolent clinical course and behavior, recurrences are relatively frequent. The prognosis depends on the most dominant histological pattern, tumor staging and surgical margin status.