Interventional bronchoscopic management of recalcitrant adenoid cystic carcinoma obstructing central airways
Pneumon, cilt.34, sa.1, 2021 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 34 Sayı: 1
- Basım Tarihi: 2021
- Doi Numarası: 10.18332/pne/136174
- Dergi Adı: Pneumon
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, EMBASE
- Anahtar Kelimeler: adenoid cystic carcinoma, central airway obstruction, interventional pulmonology
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
INTRODUCTION Adenoid cystic carcinoma (ACC) of the lung is a rare tumor with a propensity to cause central airway obstruction. Prolonged patient survival with high recurrence rates despite surgery, oncologic treatment or interventional bronchoscopic procedures (IBPs) poses long-term management challenges. With this study we aimed to review IBPs and their outcome in patients with ACC. METHODS We retrospectively reviewed the demographics, bronchoscopic findings, IBP treatment modalities and outcomes of patients with a diagnosis of ACC between January 2009 and December 2020. RESULTS There were 13 patients (9 male, 69.2%) with a mean age of 54.61±8.7 years. Trachea was the most involved site (10 cases, 76.9%) and percentage of obstruction was 77±13.9%. Bronchoscopy most commonly identified an endoluminal lesion (84.6%). There was a total of 77 procedures, including 44 rigid and 31 flexible bronchoscopies. Seven patients underwent a single procedure and 6 patients more than one procedure. Most common interventional bronchoscopic treatment modalities used were argon plasma coagulation (40.2%) and mechanical resection (38.9%). Airway stents were inserted in 4 (30.7%) patients. Airway patency was restored following first-line IBP in 93% of patients. The rate of early complications within the first 24 hours was 6.8%. Late complications were seen in 33.7% and were all stent related. No procedure related mortality was observed. CONCLUSIONS ACC affects central airways and most frequently the trachea. IBPs can be repeatedly used in the treatment of ACC because of their low early complication rates. Patients treated with airway stents should be closely followed up for late complications.