Background

There is limited clinical data to guide surgical decisions for ACC with extensive carinal involvement in the left main bronchus. In this case, it is shown that median sternotomy and CPB are feasible in this particular anatomical setting.

Case presentation

Cough and sputum were the presenting symptoms in a middle-aged female patient. Imaging examinations identified a left hilar mass that extended to involve the carina. The surgical intervention performed via a median sternotomy with CPB support encompassed both a left pneumonectomy and partial carinal resection along with reconstruction. Based on postoperative histopathological analysis, the diagnosis was adenoid cystic carcinoma (ACC); the tumor staging was determined as pT2bN0Mx, which is equivalent to stage IIA. The patient experienced an uneventful postoperative recovery, and during the 6-month follow-up, no recurrence of the tumor was observed.

Conclusion

The case illustrates that complex airway tumors can be resected with R0 margin using median sternotomy and CPB, and verifies the feasibility of surgical treatment for similar surgical cases.