Introduction: Adenoid cystic carcinoma is rare in the trachea and, due to slow growth, it can go unnoticed or be confused with other obstructive pathologies for months/years.
Case Report: We report a case of a 31-year-old woman who complained of having productive cough, wheezing and dyspnea on exertion with a progressive evolution during months. Bronchial asthma was considered and an inhaled therapy was started. After one month, she denied a significant improvement with treatment, referring inspiratory stridor. Chest X-ray showed a reduction of tracheal diameter in its distal portion and bronchoscopy revealed an extensive mass on the thoracic trachea, reducing the lumen by 80%. Laser therapy for mass resection was performed, leading to recovery of tracheal permeability. Pathological examination revealed to be consistent with adenoid cystic carcinoma. After endoscopic treatment, the patient immediately noticed a relief of symptoms.
Conclusion: Due to the extension of tumor at the time of diagnosis, adenoid cystic carcinomas are frequently unresectable. In these cases, radiotherapy and/or chemotherapy are suggested. In cases of severe tracheal obstruction, bronchoscopic resection should be performed in order to immediate recovery of tracheal lumen permeability.

Keywords: Adenoid cystic carcinoma, Trachea, Treatment