Left sleeve pneumonectomy for a rare lung tumor: A case report

Introduction and importance 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. Case presentation 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. Clinical discussion 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. Conclusion 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.
Highlights • Adenoid cystic carcinoma (AAC) of the lung is a are entity treated by a challenging surgery. • The surgical management of AAC of the lung is not evident because of its localization, and complete resection is often difficult giving the infiltrating nature of the tumor. • A bilateral thoracotomy is an interesting surgical approach for the sleeve pneumonectomy