Adenoid cystic carcinoma of trachea masked like asthma

A 42-year-old male patient was referred to hospital with symptoms of shortness of breath, wheezing and dry cough. The patient complains have begun four months ago. Due to them he was diagnosed previously with asthma, and treatment with fixed combination of inhaled corticosteroid and long-acting beta2 agonists was started, but without effect. Laboratory data and chest X-ray conducted in the hospital were normal. The spirometry showed normal FVC, FEV1 and significant reduction of PEF. The flow/volume loop was typically flattened during inspiration and expiration. It was the reason for decision that there is tracheal obstruction. The fibreoptic bronchoscopy showed an obturation, due to a tumor infiltrated the tracheal wall, and 80% stenosis of trachea. The histological result was adenoid cystic carcinoma. The patient was successfully undergoing surgical treatment. Malignant primary tumors of the trachea are very rare and adenoid cystic carcinoma is the second most common tracheal tumor. Due to its slow growth and non typical symptoms often it was misdiagnosed. The correct diagnosis and treatment is important for future survival of the patient.