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Katarzyna Szmygin-Milanowska, Paweł Krawczyk, Robert Kieszko, Janusz Milanowski
CaseRepClinPractRev 2005; 6:136-139
Background: Adenoid cystic carcinoma of the tracheobronchial tree is quite uncommon. Nevertheless, the tumour should be considered in asthma-diagnosed patients, who have insufficient improvement after a conventional anti-asthmatic treatment.Case Report: A 53-year-old woman was admitted to hospital because of severe dyspnoea, dry cough and chest pain.Conjunctival burning, lacrimation, rhinorrhea, headache, vertigo and weakness appeared after working with hay for four years. Dyspnoea on exertion, both expiratory and inspiratory, occurred two years ago. On the basis of the symptoms bronchial asthma was diagnosed. The patient has not responded to a conventional anti-asthmatic therapy, so additional diagnostic procedures have been performed. Fiberoptic bronchoscopy revealed pedunculated polypoid lesion occluding 90% of the trachea lumen. The tumour was removed during endoscopic resection by means of cold snare for polypectomy. The polyp was histopathologicaly identified as adenoid cystic carcinoma and the patient was qualified for further surgical treatment and radiotherapy.Conclusions: Our case emphasizes that late-onset dyspnoea presentation diagnosed as bronchial asthma should be an indication for bronchoscopy and computed tomography to identify other cases of bronchoconstriction, for example endobronchial or endotracheal tumours.