Subglottic adenoid cystic carcinoma mistaken for asthma

Abstract

Adenoid cystic carcinoma rarely occurs within the subglottic larynx. In this study, a case of subglottic adenoid cystic carcinoma was reported. A 54 year-old Chinese woman developed a sudden onset of chest distress and cough worsening after physical exertion, and was diagnosed with, and treated as, bronchial asthma. Regular anti-asthmatic therapy did not improve the symptoms. Until a sudden dyspnea, a cervicothoracic computerized tomography (CT) revealed that her upper airway was obstructed by a laryngeal tumor. The patient was diagnosed with a subglottic adenoid cystic carcinoma and treated with complete surgical excision and adjuvant radiation therapy. Follow-up endoscopy and laryngeal magnetic resonance imaging (MRI) at six months showed no recurrence of the tumor. The diagnosis of subglottic adenoid cystic carcinoma should be considered in patients who are characterized by dyspnea, cough, and stridor, but do not respond to regular anti-asthmatic therapy.

Fig.1

Flow-volume loop displays suggestive normal spirometric values FVC: 1.9 L (80.6%); FEV1: 1.74 L (88.3%); FEV1/FVC:91.9%

Fig.2

Dynamic Laryngoscopic finding of subglottic tumor

Fig.3

Imaging of sagittal MRI with subglottic tumor

Fig.4

Imaging of microscope with adenoid cystic carcinoma (hematoxylin and eosin (H&E), ×400)