Rare occurrence of tracheal acinic cell carcinoma causing central airway obstruction in a young adult

A 22-year-old woman presented with intermittent blood-tinged sputum for about 3 years. She reported experiencing exertional dyspnoea and had no history of chronic disease, family history or smoking. On physical examination, mild coarse breathing sounds and wheezing on the upper sternum were auscultated. Lab results were non-specific. Chest CT scan (figure 1A,B) revealed a heterogeneous enhancing endotracheal mass of approximately 1.9 cm at mid-trachea extending to the boundary of the right tracheal wall or through the tracheal wall but not invading adjacent structures. The bronchoscopy showed a tracheal mass characterised by a lobulated surface with hypervascularity (figure 1C). 2-Deoxy-2-[18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT demonstrated mild to moderate uptake increase of FDG (figure 1D) and no definitive invasion to the neighbouring structures was observed on images (figure 1E). The tracheal mass was resected with a sufficient resection margin via uniportal video-assisted thoracic surgery and was reconstructed by end-to-end anastomosis. Figure 1 (A, B) Images on contrast-enhanced chest CT showing a 1.9×1 cm endotracheal mass with heterogeneous enhancement at mid-trachea (yellow arrow). (C) Initial diagnostic flexible fibreoptic …