Adaptive radiotherapy in a case of adenoid cystic carcinoma of bronchus and its favourable impact on treatment outcome: A case report

Abstract

Adenoid cystic carcinoma is a very rare malignancy commonly originating from the salivary glands of the head and neck. It is again very scantily seen in sites like the bronchus. Surgical resection is the mainstay of treatment but many a times the tumour site and size preclude a favourable outcome of surgery and the patient is advised for other forms of local treatment like Radiotherapy. Here, we present a case report of a young female with primary adenoid cystic carcinoma of the bronchus. The tumour was located in the carina and the left bronchus which was obstructing the airway resulting in collapse of the left lung, this resulted in shifting the mediastinum and abdominal structures in to the thorax. The tumour was inoperable and was advised for radiotherapy. The adenoid cystic carcinoma of the bronchus with such presentation and mediastinal shift is a rare and special situation. During radiotherapy the collapsed lung was inflated which resulted in the shifting of the tumour and other normal structures. The use of adaptive radiotherapy in such situation helped us to achieve improved dose delivery to the tumour and this resulted in an improved survival for the patient as compared to the available literature.