[A case of adenoid cystic carcinoma presenting with stridor and which was treated by reversed gamma type stent placement].

A 66-year-old man was admitted to Saiseikai Suita Hospital with stridor and dyspnea. The flow-volume curve showed central airway obstruction pattern. Although a P-A chest roentogenogram was normal, chest tomogram demonstrated a tumor shadow in the lower portion of the trachea. Chest CT examination demonstrated a tumor arising from the posterior wall of the lower portion of the trachea and stenosis with wall thickening extending from the lower portion of the trachea to both main bronchi. Bronchofiberscopic examination revealed polypoid tumors obstructing the lower portion of the tracheal lumen, and biopsy was subsequently performed. On the night immediately after the bronchofiberscopic examination, the patent suddenly choked, and emergency intubation was performed. Adenoid cystic carcinoma was diagnosed on biopsy and we decided to place a spiral Z-stent. A reversed gamma-type stent placement was used. The first spiral Z-stent extended from the trachea to the right main bronchus and the second spiral Z-stent was placed in the left main bronchus through the first stent. Following the spiral Z-stent placement radiotherapy was performed. Spiral Z-stent placement resulted in dilation of the stenotic trachea and both main bronchi.