Adenoid cystic carcinoma of laryngotracheal areas are rare. They have no causal relation with smoking unlike the commoner squamous cell carcinoma of trachea and larynx. It is a low grade malignancy mainly affecting individuals of 4th-5th decade of life. They presents with breathlessness, cough and ocassionally hemoptysis and are misdiagnosed as asthma or reactive airway disease. The prolonged clinical course with late onset locoregional and or distant metastasis tends to be characteristic. Though they mandate surgical resection, adjacent critical structures hinder complete resection. Hence adjuvant radiation therapy is suggested. However, radiation therapy when offered as primary treatment for advanced disease, also show fairly comparable survival benefits, as in the two cases reported.
