Zhen Yang Yafei Wang ^* Zhenhua Li Shuang Geng Yi Hu ^* Hongling Hu ^*

• Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China

The treatment of recurrent tracheal adenoid cystic carcinoma (TACC), a rare pulmonary malignant tumor, typically involves bronchoscopic interventional therapy for patient's ineligible for surgery or external radiotherapy. This report describes an innovative treatment approach for TACC, initially managed with interventional bronchoscopy and subsequently with a Yshaped airway stent loaded with 125 I seeds, following recurrence after 2 years.A 50-year-old male presented with intermittent coughing for 2 months and was admitted to the hospital after the discovery of TACC a month earlier. Preoperative bronchial artery embolization was performed to reduce the risk of bleeding, followed by bronchoscopic tumor resection in January 2017 using an electric loop at the base, complemented by argon plasma coagulation (APC) and cyrotherapy. Although short-term outcomes were favorable, the long-term prognosis remained suboptimal. Due to tumor recurrence, airway tumor resection and implantation of a 125 I seeds stent were performed under bronchoscope guidance in early 2019. The stent was removed 5 months later. The patient tolerated the procedure well and exhibited no signs of relapse or progression during the 5-year postoperative follow-up period. This case illustrates the successful application of a stent loaded with 125 I seeds for treating unresectable TACC.Conclusions: Treatment of TACC with a covered airway stent loaded with 125 I seeds may be a safe, effective and scalable method.