Primary Salivary Gland Malignancy of Trachea: A Clinical Masquerader

Primary tracheal malignancies are rare and present with non specific symptoms hence delaying the diagnosis. A 41-year-old male presented with repeated paroxysmal episodes of breathlessness for which he was being treated with bronchodilators and steroids. Computed Tomography (CT) chest was done revealing a small polypoidal mass lesion arising from lower trachea/carina. On fibre optic bronchoscopy an infiltrative growth was seen at the lower end of trachea following which biopsy was obtained. On histopathologic examination a diagnosis of primary adenoid cystic carcinoma was made. It was concluded that in a case of refractory obstructive pulmonary disease, primary tracheal tumours should be considered as an important differential diagnosis. CT chest, bronchoscopy and biopsy play a vital role in making an accurate diagnosis of such a clinical masquerader.