Indian Journal of Nuclear Medicine

INTERESTING IMAGE
Year
: 2019  |  Volume : 34  |  Issue : 3  |  Page : 249--250

Adenoid cystic carcinoma of trachea: Findings on 18F FDG positron emission tomography-computed tomography


Sarthak Tripathy, Shamim Ahmed Shamim, Abhishek Behera, Chandrasekhar Bal, Rakesh Kumar 
 Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Prof. Rakesh Kumar
Head, Division of Diagnostic Nuclear Medicine, Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
India

Abstract

Adenoid cystic carcinoma (ACC) of the trachea is the second most common tumor of trachea after squamous cell carcinomas. It arises from the submucosal layer and predominantly has a rapid locoregional spread. We describe the 18F FDG positron emission tomography-computed tomography findings of a 51-year-old woman, a biopsy-proven case of ACC of trachea who underwent the scan for initial staging.



How to cite this article:
Tripathy S, Shamim SA, Behera A, Bal C, Kumar R. Adenoid cystic carcinoma of trachea: Findings on 18F FDG positron emission tomography-computed tomography.Indian J Nucl Med 2019;34:249-250


How to cite this URL:
Tripathy S, Shamim SA, Behera A, Bal C, Kumar R. Adenoid cystic carcinoma of trachea: Findings on 18F FDG positron emission tomography-computed tomography. Indian J Nucl Med [serial online] 2019 [cited 2019 Oct 21 ];34:249-250
Available from: http://www.ijnm.in/text.asp?2019/34/3/249/260749


Full Text



A 51-year old woman presented with chief complaints of nonproductive cough with dyspnea for the past 6 months to pulmonology outpatient department. On suspicion of bronchogenic carcinoma,18F FDG positron emission tomography-computed tomography (PET-CT) was advised to look for sites of metabolically active disease. Maximum intensity projection images of the scan showed focal area of FDG uptake in the mediastinal region [Figure 1]a, solid blue arrow]. [Figure 1]b [solid white arrow] represents the axial chest CT image showing an extraluminal lesion measuring approximately 1.4 cm × 1.4 cm arising from the trachea just before its bifurcation and also involving the carina. The lesion showed increased FDG uptake in the fused transaxial PET-CT images [Figure 1]c, solid red arrow]. [Figure 1]d [solid yellow arrow] and e [solid green arrow] represents coronal and sagittal fused 18F FDG PET-CT images respectively, showing increased FDG uptake in the tracheal lesion. No distant metastasis was recorded on PET-CT scan and the patient underwent surgery and histopathology was diagnostic of primary adenoid cystic carcinoma (ACC) of the trachea.{Figure 1}

Tracheal ACC originates from the submucosal glands of the airway are often misdiagnosed as asthma or bronchitis and accounts for about 10%–20% of the malignant tracheal tumor.[1],[2] Due to rarity of this neoplasm in general population, there are not many published reports highlighting the utility of PET-CT in this type of tumor. Although some reports suggest that there is no special tumor site predilection,[3] Huo et al. in their series found lower one third of trachea to be one of the favored sites.[4] Metastases to cervical lymph nodes are a rare event; ACC spreads through a hematogenous route with distant metastases, especially to lungs, brain, bone and liver.[5],[6] In our case, we had a localized disease with no nodal or visceral metastases; however, keeping in view its tendency to metastasize initially as well as late up to 15 years after the initial diagnosis,[7] the authors advocate use of 18F FDG PET-CT in workup algorithm of ACCs, especially for restaging purpose.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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