Bouacida Imen, Essid Rime, Bousnina Mouna, Zribi Hazem, Ouerghi Sonia, Merghli Adel
Thoracic and Cardiovascular Surgery Department, Abderahmen Mami hospital, Tunis El Manar University, Tunisia.
Thoracic and Cardiovascular Surgery Department, Abderahmen Mami hospital, Tunis El Manar University, Tunisia.
Int J Surg Case Rep. 2021 Dec;89:106528. doi: 10.1016/j.ijscr.2021.106528. Epub 2021 Oct 20.
Primary adenoid cystic carcinoma (ACC) of the lung is extremely rare. This tumor can be asymptomatic or have non characteristics symptoms, and the diagnosis is often late. The treatment of choice is surgery when it's possible.
We herein report the case of a young patient with ACC of the left main bronchus. He had dyspnea and chest pain for 6 months. Complete atelectasis of the left lung was found on the chest x-ray. Bronchoscopy showed a tumor obstructing the LMB and invading the carina. The CT scan revealed a 5 cm tumor obstructing the left main bronchus (LMB) with extension to the carina and thoracic trachea. The extension assessment was without abnormalities. The treatment was surgical. A left carinal pneumonectomy by double lateral thoracotomy was performed. The postoperative results were satisfactory. There was no recurrence with a follow-up of 2 years.
The therapeutic management of ACC is essentially based on surgical resection, which should be as radical as possible. However, complete resection is often difficult given the infiltrating nature of the tumor.
Sleeve pneumonectomy with carinal resection is a curative option for patients with ACC of the main bronchi and carina that require expertise of the surgeons.
原发性肺腺样囊性癌（ACC）极为罕见。该肿瘤可能无症状或有非特异性症状，诊断往往较晚。可能的情况下，首选治疗方法是手术。
我们在此报告一例左主支气管ACC的年轻患者。他有6个月的呼吸困难和胸痛症状。胸部X线检查发现左肺完全肺不张。支气管镜检查显示肿瘤阻塞左主支气管并侵犯隆突。CT扫描显示一个5厘米的肿瘤阻塞左主支气管（LMB），并延伸至隆突和胸段气管。扩展评估无异常。治疗方法为手术。通过双侧开胸进行左隆突全肺切除术。术后结果令人满意。随访2年无复发。
ACC的治疗管理主要基于手术切除，应尽可能彻底。然而，鉴于肿瘤的浸润性，完全切除往往困难。
对于需要外科医生专业技术的主支气管和隆突ACC患者，袖状肺叶切除术加隆突切除是一种治愈性选择。
