Adenoid cystic carcinoma of the trachea
Middle aged male admitted with positional airway compromise. Obstruction?
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Large mass in the proximal trachea, just above the level of the manubrium. This looks adherent to the wall of the trachea between 6 and 9 o'clock. 90% occlusion of the tracheal lumen at this level.
Bilateral lower lobe consolidation, much more pronounced on the left, in keeping with aspiration pneumonia. No significant mediastinal lymphadenopathy.
Adenoid cystic carcinoma of the trachea is one of the less common causes of a tracheal mass. As with this malignancy at other sites, it is locally aggressive and has a propensity for perineural spread.
Presentation is typically with airway symptoms due to luminal obstruction.