Adenoid cystic carcinoma Research Papers (original) (raw)

BACKGROUND. Adenoid cystic carcinoma of the sinonasal tract is a rare cancer that accounts for 10% of all malignancies at this site. The objective of the current study was to evaluate prognostic factors, treatment outcomes, recurrence... more

BACKGROUND. Adenoid cystic carcinoma of the sinonasal tract is a rare cancer that accounts for 10% of all malignancies at this site. The objective of the current study was to evaluate prognostic factors, treatment outcomes, recurrence patterns, and survival rates for sinonasal adenoid cystic carcinoma. METHODS. A retrospective chart review was performed at an academic tertiary referral center. Between 1990 and 2004, 105 patients were evaluated for adenoid cystic carcinoma of the sinonasal tract at a single institution. Demographics, presentation, anatomic site, Tumor, Lymph Node, Metastasis (TNM) classification, pathology, treatment, recurrences, and survival were evaluated. RESULTS. One hundred five patients with adenoid cystic carcinoma were evaluated, including 58 women and 47 men. Their median age was 50 years, and the mean follow-up was 47 months. The maxillary sinus (47%) and the nasal cavity (30%) were the most common primary tumor sites. The majority of patients presented with T3/T4 (76.7%), N0 (98%), M0 (97%) disease. Eighty-four percent of patients underwent surgery and received postoperative radiation as treatment for their primary disease. The local recurrence rate was 30%, and the distant metastases rate was 38%. The 5-year overall survival and disease specific survival rates were 62.9% and 70.9%, respectively. CONCLUSIONS. Adenoid cystic carcinoma of the paranasal sinuses is a rare disease, and the ideal treatment paradigm has yet to be defined. The current data suggested that surgical resection with postoperative radiation therapy offers durable local control and compares favorably with historic data. Although local recurrences develop in a significant percentage of patients, survival from this disease exceeds that of other sinonasal malignancies.

Tracheal adenoid cystic carcinoma which is an uncommon tracheal malignancy may manifest an atypical clinical course. In case of tracheal localisation, despite technical difficulties, it shouldn't be avoided from surgical treatment. We... more

Tracheal adenoid cystic carcinoma which is an uncommon tracheal malignancy may manifest an atypical clinical course. In case of tracheal localisation, despite technical difficulties, it shouldn't be avoided from surgical treatment. We present an uncommon surgical procedure performed to our patient with tracheal adenoid cystic carcinoma in whom a slow clinical course and a good prognosis occured, despite positive resection margin after surgical treatment.

To reevaluate breast aspirates showing extracellular hyaline material (EHM) and globules to assess if clinicoradiologic and cytologic features could help in differentiating between benign and malignant lesions, especially collagenous... more

To reevaluate breast aspirates showing extracellular hyaline material (EHM) and globules to assess if clinicoradiologic and cytologic features could help in differentiating between benign and malignant lesions, especially collagenous spherulosis (CS) and adenoid cystic carcinoma (ACC). Fine needle aspiration was performed on 884 patients with breast lumps. The cytomorphologic features of 6 cases showing EHM, including classic hyaline globules (HGs), were analyzed in detail. Three cases also had hemorrhagic nipple discharge. Tissue diagnosis (4) and mammography (6) were available. Aspirate smears revealed high cellularity composed of monolayers: clusters of uniform, small cells; EHM; and HGs surrounded by similar cells. Benign naked nuclei and stromal fragments (4), nuclear pleomorphism (3), apocrine cells (2), foam cells (2), naked HGs (2) and spindle cells in proximity to HGs were also seen (4). Nipple discharge smears showed foam cells, erythrocytes (3) and epithelial cell cluster...

Adenoid cystic carcinoma (ACC) are uncommon tumors, representing about 10% to 15% of head and neck tumors. We compare the survival and control rates at our institution with those reported in the literature, and examine putative predictors... more

Adenoid cystic carcinoma (ACC) are uncommon tumors, representing about 10% to 15% of head and neck tumors. We compare the survival and control rates at our institution with those reported in the literature, and examine putative predictors of outcome. All patients registered with the tumor registry as having had ACC were identified. Demographic and survival variables were retrieved from the database. Additionally, a chart review of all patients was done to obtain specific information. Minor gland tumors were staged using the American Joint Committee on Cancer's criteria for squamous cell carcinomas in identical sites. Histopathologic variables retrieved included grade of the tumor, margins, and perineural invasion. Treatment modalities, field sizes, and radiation doses were recorded in applicable cases. An effort to retrieve archival tumor specimens for immunohistochemical analysis was undertaken. A total of 69 patients were treated for ACC from 1955 to 1999. One patient, who presented with fatal brain metastasis, was excluded from further analysis. Of the remaining 68 patients, 30 were men and 38 were women. The average age at diagnosis was 52 years, and mean follow-up was 13.2 years. Mean survival was 7.7 years. Overall survival (OS) rates at 5, 10, and 15 years were 72%, 44%, and 34%, and cause-specific survival was 83%, 71%, and 55%, respectively. Recurrence-free survival rates were 65%, 52%, and 30% at 5, 10, and 15 years, with a total of 29 of 68 (43%) eventually suffering a recurrence. Overall survival was adversely affected by advancing T and AJCC stage. Higher tumor grades were also associated with decreased OS, although the numbers compared were small. Primaries of the nasosinal region fared poorly when compared with other locations. Total recurrence-free survival, local and distant recurrence rates were distinctly better in primaries of the oral cavity/oropharynx when compared with those in other locations. Reduced distant recurrence-free survival was significantly associated with increasing stage. No other variables were predictive for recurrence. Additionally, we found that nasosinal tumors were more likely to display higher stage at presentation, and were more often associated with perineural invasion. Also of interest was the association of perineural invasion with margin status, with 15 of 20 patients with positive margins displaying perineural invasion, while only 5 of 17 with negative margins showed nerve invasion (P = 0.02). On immunohistochemistry, 2 cases of the 29 (7%) tumor specimens found displayed HER-2/neu positivity. No correlation between clinical behavior and positive staining could be demonstrated. Our data concur with previous reports on ACC in terms of survival and recurrence statistics. Stage and site of primary were important determinants of outcome. Grade may still serve a role in decision making. We could not demonstrate any differences attributable to primary modality of therapy, perhaps due to the nonrandomization of patients into the various treatment tracks and the inclusion of palliative cases. Similarly, perineural invasion, radiation dose and field size, and HER-2/neu positivity did not prove to be important factors in our experience.

Seventy-nine patients with adenoid cystic carcinoma arising in salivary glands were studied to determine whether a correlation existed between the morphologic features of the tumor and the prognosis. Three histologic grades were... more

Seventy-nine patients with adenoid cystic carcinoma arising in salivary glands were studied to determine whether a correlation existed between the morphologic features of the tumor and the prognosis. Three histologic grades were established: Grade I, tumors with tubular and cribriform areas but without solid components; Grade 11, cribriform tumors that were either pure or mixed with less than 30% of solid areas; and Grade 111, tumors with a predominantly solid pattern. Cumulative survival rates at 15 years were 39%, 26%, and 5%, for Grades I, 11, and 111, respectively. Grade 111 tumors were larger, recurred frequently, and killed the patients within 4 years. Grade I lesions were smaller, were amenable to complete surgical excision, and had a protracted clinical course. Grade I1 tumors lay between the other two forms both clinically and pathologically. Other important prognostic features of the adenoid cystic carcinoma were its primary site, its presence or absence at surgical margins, and the anatomic structures it involved.

Opinion statement Malignancies of the nasal cavity and paranasal sinuses represent a wide spectrum of histologies, tissues of origin, and anatomic primary sites. The inherent difficulty in generalizing treatment approaches is obvious,... more

Opinion statement Malignancies of the nasal cavity and paranasal sinuses represent a wide spectrum of histologies, tissues of origin, and anatomic primary sites. The inherent difficulty in generalizing treatment approaches is obvious, given the numerous variables associated with the broadly-based term, paranasal sinus malignancy (PNSCa). Nevertheless, the majority of epithelial and salivary malignancies of this region (ie, squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, sinonasal undifferentiated carcinoma, and esthesioneuroblastoma) require surgical intervention as part of any treatment regimen. Recent trends have broadened the indications for chemotherapeutic and radiotherapeutic options in the management of advanced PNSCa. Nonepithelial malignancies, including the wide variety of sarcomas arising in this region, most commonly require multimodality treatment including chemotherapy, radiation, and/or surgery for definitive treatment. Moreover, the proximity of the nasal cavity and paranasal sinuses to structures including the orbit, dura, brain, cranial nerves, and carotid arteries mandates careful radiologic and neurologic evaluations throughout the course of the disease. Surgical advances now permit complex tumor removal and reconstruction surrounding these structures resulting in functional and cosmetic improvements when compared to earlier techniques. However, additional clinical trials are necessary to systematically evaluate the locoregional control, organ-preservation strategies, and survival related to the variety of treatments currently available.

Background. Maxillary reconstruction continues to challenge in terms of optimal aesthetic and functional outcomes. The aim of this study was to describe the utility of the scapular angle osteomyogenous flap in a series of maxillectomy... more

Background. Maxillary reconstruction continues to challenge in terms of optimal aesthetic and functional outcomes. The aim of this study was to describe the utility of the scapular angle osteomyogenous flap in a series of maxillectomy patients and to examine the donor site morbidity.

Despite technical advances over the past 3 decades, subtotal, total, and extended total maxillectomy defects remain challenging reconstructive problems. In particular, postoncologic resection of the maxilla results in complex... more

Despite technical advances over the past 3 decades, subtotal, total, and extended total maxillectomy defects remain challenging reconstructive problems. In particular, postoncologic resection of the maxilla results in complex 3-dimensional defects of the midface, which cause severe functional and esthetic deformities. Such defects generally require composite tissue flaps for reconstruction. Rebuilding the palate and maxilla is especially challenging because it requires reconstitution of the facial buttresses, occlusion, replacement of bony hard palate, and the thin intraoral and intranasal lining which normally constitute the soft palate. Various methods of reconstruction have been applied to this area in search of an ideal soft tissue-bone flap to restore the bony framework of the maxilla and palate while providing an internal lining. Osteocutaneous and osteomuscular flaps such originating from the scapular, iliac, peroneal, and radial vascular systems have been attempted with good success.

El síndrome de Brooke-Spiegler constituye una genodermatosis muy poco frecuente, de herencia autosómica dominante y penetrancia variable, en el que existe una predisposición a la formación de distintas neoplasias anexiales debido a una... more

El síndrome de Brooke-Spiegler constituye una genodermatosis muy poco frecuente, de herencia autosómica dominante y penetrancia variable, en el que existe una predisposición a la formación de distintas neoplasias anexiales debido a una alteración en la unidad folículo-sebáceoapocrina 1-4 . Clínicamente se caracteriza por la aparición simultánea y progresiva de múltiples cilindromas en el cuero cabelludo, tricoepiteliomas faciales y, en ocasiones, espiradenomas ecrinos 1-4 .

A case is presented of a patient with severe and chronic pain in the orbital region, which was relieved by retrobulbar injection of absolute alcohol. The management of chronic pain in the orbital region has received little attention and... more

A case is presented of a patient with severe and chronic pain in the orbital region, which was relieved by retrobulbar injection of absolute alcohol. The management of chronic pain in the orbital region has received little attention and the literature is reviewed. A 52-year-old man with adenoid cystic carcinoma of the maxillary sinus was suffering from severe pain, especially in the left orbital region. There was also pain from ocular exposure and compression caused by the tumour. Magnetic resonance imaging (MRI) revealed spread of tumour to both orbits, particularly on the left. Multiple debulking surgery and various treatment modalities offered no relief from his pain. A single retrobulbar injection of 2 mL of absolute alcohol, was placed into the putative orbital apex. As a consequence of the injection, he had complete resolution of his pain in the 6 months prior to his death. Retrobulbar injection of alcohol offers effective pain relief in certain specific conditions characteris...

Primary adenoid cystic carcinoma of lung is a rare tumour. It is a slowly growing, indolent tumour. Average time that elapses before diagnosis is reported to be two years. We report the case of a patient who remained well inspite of... more

Primary adenoid cystic carcinoma of lung is a rare tumour. It is a slowly growing, indolent tumour. Average time that elapses before diagnosis is reported to be two years. We report the case of a patient who remained well inspite of harbouring primary adenoid cystic carcinoma of lung for 15 years.

A wide range of disease process involve the lacrimal gland/fossa. In this pictorial review, we use histology-proven cases to illustrate conditions that affect the lacrimal gland/fossa. CT and MRI features of neoplastic, inflammatory,... more

A wide range of disease process involve the lacrimal gland/fossa. In this pictorial review, we use histology-proven cases to illustrate conditions that affect the lacrimal gland/fossa. CT and MRI features of neoplastic, inflammatory, infiltrative, and developmental conditions are discussed.

Objectives: Adenoid cystic carcinoma (ACC) is a very rare epithelioid tumor with different prognostic factors relating to overall survival. This study aims to analyze the prognostic factors, outcome and the value of surgical therapy on... more

Objectives: Adenoid cystic carcinoma (ACC) is a very rare epithelioid tumor with different prognostic factors relating to overall survival. This study aims to analyze the prognostic factors, outcome and the value of surgical therapy on recurrent disease. Materials and methods: From 1992 to 2006, a total of 33 patients with ACC originating in minor salivary glands of the oral cavity were clinicopathologically reviewed. Clinical and histological data was analyzed by univariate analysis using the log-rank test. Results: 64% of patients had a low-grade and 36% had a high grade disease. The 2-, 5-and 10-year survivals were 89.7%, 62.1% and 54.2%. The T category ( p = 0.001), N category ( p = 0.027), UICC stage ( p < 0.0001), and resection margins ( p = 0.024) influenced survival. Salvage treatment influenced patient's overall survival ( p = 0.002). Conclusion: This study confirms that in ACC T category, N category, UICC stage, and resection margin status correlates well with prognosis. Salvage surgery of patients with recurrent ACC should be performed if possible as the survival is significantly increased. #

Adenoid cystic carcinoma (ACC) constitutes about 4% of salivary epithelial tumors and is the second common malignant epithelial salivary gland tumor involving both the major and minor salivary glands. High grade transformation in ACC is a... more

Adenoid cystic carcinoma (ACC) constitutes about 4% of salivary epithelial tumors and is the second common malignant epithelial salivary gland tumor involving both the major and minor salivary glands. High grade transformation in ACC is a recently recognized entity with only a few cases reported in literature. We report the first case of ACC with high grade transformation involving the parotid. A 54-year-old man with a history of right parotid painful swelling from 1.5 years presented with recent increase in size of the swelling and facial paresis of 2 months duration. The locally invasive salivary neoplasm was composed predominantly of an undifferentiated carcinoma with foci of conventional ACC occupying less than 10% of tumor area. Immunohistochemical study of the undifferentiated component as compared to conventional ACC showed greater over-expression of p53 and Ki-67. Her-2/Neu was negative in both components. Recognition of occasional clusters of basaloid cells and hyaline globules in association with larger poorly differentiated malignant cell population in aspiration smears can help in cytological diagnosis. The acquisition of high proliferation index and over-expression of p53 may be the probable factors involved in the pathogenesis of high grade transformation in a conventional ACC.

Collagenous spherulosis of the breast is distinctive breast histological finding characterised by the accumulation of basement membrane material in form of eosinophilic or rarely basophilic spherules that exhibit concentric and radiating... more

Collagenous spherulosis of the breast is distinctive breast histological finding characterised by the accumulation of basement membrane material in form of eosinophilic or rarely basophilic spherules that exhibit concentric and radiating fibrillar patterns. It is usually an incidental microscopic uni- or multifocal finding that occurs adjacent to benign proliferative lesions, but it can be also coexistent with malignant breast processes. Its occurrence within a malignant process is exceptional. We present a case of collagenous spherulosis of the breast associated with poorly differentiated carcinoma in situ in a 54-year-old woman. This rare change can be misinterpreted as adenoid cystic carcinoma.

Intraoral tumors are the main causes of the intraoral and maxillofacial defects. Skin grafts and several soft tissue flaps can be used to reconstruct the intraoral defects including local, regional, and free flaps. Skin grafts are used to... more

Intraoral tumors are the main causes of the intraoral and maxillofacial defects. Skin grafts and several soft tissue flaps can be used to reconstruct the intraoral defects including local, regional, and free flaps. Skin grafts are used to cover the small and unilayered defects. Skin grafts contract over time after the operation and especially after radiotherapy. Also, skin grafts are used to cover some flaps such as the buccal mucosa fat pad flap, which is capable of reconstructing the small-to medium-sized intraoral defects ranging in diameter from 1 to 4 cm. The other locoregional options to reconstruct the medium-sized defects include temporalis muscle flap, facial artery musculomucosal flap, myocutaneous platysma flap, infrahyoid myocutaneous flap, submental island flap, and superficial musculoaponeurotic system (SMAS) flap. For large defects, regional or free flaps are used such as the pectoralis major flap and trapezius myocutaneous flap. They provide enough tissue; however, its hair-bearing nature in men and the need to reposition the patient on the operating table are the disadvantages of these flaps. Free forearm flap provides thin, pliable tissue; however, the donor site of this flap is in a remote area from the defect and requires two surgical teams. Also, microsurgical training is required and the operation time is prolonged compared with local flaps.

BACKGROUND. This study was conducted to assess the effectiveness of the 1997 American Joint Committee on Cancer (AJCC) staging system to predict survival and local control of patients with maxillary sinus carcinoma and to identify... more

BACKGROUND. This study was conducted to assess the effectiveness of the 1997 American Joint Committee on Cancer (AJCC) staging system to predict survival and local control of patients with maxillary sinus carcinoma and to identify significant factors for overall survival, local control, and distant metastases in patients with these tumors.

ABSTRACT Adenoid cystic carcinoma (ACC) was first described in 1853 and 1854 by three french scientists, Robin, Lorain and Laboulbène. ACC is a rare cancer of the head and neck (about 1%) and it comprises from 6% to 10% of all malignant... more

ABSTRACT Adenoid cystic carcinoma (ACC) was first described in 1853 and 1854 by three french scientists, Robin, Lorain and Laboulbène. ACC is a rare cancer of the head and neck (about 1%) and it comprises from 6% to 10% of all malignant tumors of the salivary glands. 15%–30% of these tumors are located in submandibular gland, 30% occur in small salivary glands (in the palate, tongue, mouth, nose, sinuses, mucous membrane of the cheeks) and about 6% in parotid gland. Because of its specificity ACC is a challenge for the doctor – it is usually recognized at an advanced stage, spreads along the nerves, it has a high propensity for recurrence, often gives distant metastases, 10-year survival are very small.

Aims and objectives: The aim of this paper was to study the impact of neoadjuvant chemoradiation on downstaging of locally advanced rectal carcinoma, sphincter saving procedures and toxicity profile of chemoradiation. Method: 31 patients... more

Aims and objectives: The aim of this paper was to study the impact of neoadjuvant chemoradiation on downstaging of locally advanced rectal carcinoma, sphincter saving procedures and toxicity profile of chemoradiation.
Method: 31 patients were studied who had locally advanced adenocarcinoma of rectum. They were treated preoperatively with 20 frations of 225 cGy (5 days/wk) radiation (total of 45Gy over 28 days). Chemotherapy consisted of 5-FU (500mg/m.sq) only for day 1, 2, & 3. After an interval of of 4-6 wks, all patients were submitted to surgery.The principles of TME was
Results: The median follow up in our study was 1year. At 1 year the overall survival in operated cases was 100% with no disease relapse. 67% of patients underwent low anterior resection,6.5% had proctosigmoidectomy with end colostomy,16.5% had a palliative surgical procedure, 6.5% became non compliant after neoadjuvant and 3.2% expired preoperatively during chemoradiation. At the time of surgery 82.6% of patients had pathological downstaging of tomour and 45.4% had lymphnode downstaging.Consequently 67.7% of patients underwent a sphincter preserving surgical procedure.
The incidence of complication was 29% with grade 2 mucositis and 9.7% with grade 1 mucositis. Myelosuppression was seen in non.
Conclusion: Significant downstaging of disease was seen with this regime of treatment and with improved subsequent sphincterv preserving procedures with acceptable toxicity profile.

Purpose: This study summarizes the experience with raster scanned carbon ion radiation therapy (RT) at the Gesellschaft fü r Schwerionenforschung (GSI), Darmstadt, Germany since 1997. Methods and Materials: Between December 1997 and... more

Purpose: This study summarizes the experience with raster scanned carbon ion radiation therapy (RT) at the Gesellschaft fü r Schwerionenforschung (GSI), Darmstadt, Germany since 1997. Methods and Materials: Between December 1997 and December 2002, 152 patients were treated at GSI with carbon ion RT. Eighty-seven patients with chordomas and low-grade chondrosarcomas of the skull base received carbon ion RT alone (median dose 60 GyE); 21 patients with unfavorable adenoid cystic carcinomas and 17 patients with spinal (n ‫؍‬ 9) and sacrococcygeal (n ‫؍‬ 8) chordomas and chondrosarcomas were treated with combined photon and carbon ion RT. Twelve patients received reirradiation with carbon ions with or without photon RT for recurrent tumors. Furthermore, 15 patients with skull base tumors other than chordoma and low-grade chondrosarcoma were treated with carbon ions. Results: Actuarial 3-year local control was 81% for chordomas, 100% for chondrosarcomas, and 62% for adenoid cystic carcinomas. Local control was obtained in 15/17 patients with spinal (8/9) and sacral (7/8) chordomas or chondrosarcomas and in 11/15 patients with skull base tumors other than chordomas and low-grade chondrosarcomas, respectively. Six of 12 patients who received reirradiation are still alive without signs of tumor progression. Common Toxicity Criteria Grade 4 or Grade 5 toxicity was not observed. Conclusion: Carbon ion therapy is safe with respect to toxicity and offers high local control rates for skull base tumors such as chordomas, low-grade chondrosarcomas, and unfavorable adenoid cystic carcinomas.

Background Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal. Design Retrospective. Results The patients included 11 men and 6 women, aged 33-82 years (mean,... more

Background Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal. Design Retrospective. Results The patients included 11 men and 6 women, aged 33-82 years (mean, 59.5 years). Patients presented clinically with a mass of the outer half of the external auditory canal (n = 14), hearing changes (n = 5), drainage (n = 4), or paralysis of the facial nerve (n = 3). The polypoid masses ranged in size from 0.5 to 3 cm in greatest dimension (mean, 1.8 cm). Histologically, the tumors demonstrated a solid to cystic pattern, composed of an infiltrating glandular to cribriform arrangement of epithelial cells. Histologic features included a dual cell population (although not the dominant histology), increased cellularity, moderate to severe nuclear pleomorphism, irregular nucleoli, increased mitotic figures (mean, 3/10 HPF), including atypical forms, and tumor necrosis (n = 2). Tumors were divided into three types of adenocarcinoma based on pattern of growth and cell type (ceruminous, NOS [n = 12], adenoid cystic [n = 4], mucoepidermoid [n = 1]). CK7 and CD117 highlighted the luminal cells, while S1-00 protein showed a predilection for the basal cells of ceruminous and adenoid cystic carcinomas. Metastatic adenocarcinoma or direct extension from salivary gland neoplasms are the principle differential considerations. Surgical resection was used in all patients with radiation used in four patients. Eleven patients were alive or had died of unrelated causes without evidence of disease (mean, 11.2 years); six patients had died with disease (mean, 4.9 years), all of whom had developed local recurrence. Conclusion Ceruminous-type carcinomas, with the exception of ceruminous mucoepidermoid carcinoma, all demonstrated a dual cell population of basal myoepithelial-type cells and luminal apocrine cells. The specific histologic sub-type does not influence the long-term patient outcome.

Intraoperative three-dimensional (3D) "navigation" has siginificantly improved patient safety during operative procedures on the paranasal sinuses and the frontal skull base. The ISG Viewing Wand (ISG Technologies, Mississauga, Ontario,... more

Intraoperative three-dimensional (3D) "navigation" has siginificantly improved patient safety during operative procedures on the paranasal sinuses and the frontal skull base. The ISG Viewing Wand (ISG Technologies, Mississauga, Ontario, Canada) is now used routinely for such procedures in our hospital at the present time. Current use with our radiological and intraoperative protocols has demonstrated a clinical accuracy of 1-2 mm. Initial experience with the ARTMA Virtual Patient (ARTMA Biomedical, Vienna, Austria) has allowed endoscopic 3D navigation by using augmented reality techniques and has been found to be very promising. We present our experience with these systems and discuss the impact of these unique techniques on computer-assisted surgery (CAS) in otorhinolaryngology and head and neck surgery.

Adenoid cystic carcinoma is a common malignant neoplasm originated from salivary glands. The clinical and pathological findings typical of this tumor include slow growth, perineural invasion, and potential local recurrence. It accounts... more

Adenoid cystic carcinoma is a common malignant neoplasm originated from salivary glands. The clinical and pathological findings typical of this tumor include slow growth, perineural invasion, and potential local recurrence. It accounts for nearly 2% to 4% of head and neck area tumors. In minor salivary glands it usually affects the palate. We described herein the case of a patient who presented a posterior tongue lesion, which was treated with surgery and radiotherapy as additional treatment. We also carried out a brief literature review on the subject.

Histopathology 41, 250-259 believe that, whilst polymorphous low-grade adenocarcinoma is certainly far less aggressive than, for example, adenoid cystic carcinoma, it nevertheless remains a true malignancy with a potential to prove fatal... more

Histopathology 41, 250-259 believe that, whilst polymorphous low-grade adenocarcinoma is certainly far less aggressive than, for example, adenoid cystic carcinoma, it nevertheless remains a true malignancy with a potential to prove fatal in a minority of patients.

Six cases of invasive breast carcinoma with unusual morphological features are reported. The ages of the female patients ranged from 46 to 79 years (mean 60.5). All tumours had areas typical of an adenomyoepithelioma. In three cases... more

Six cases of invasive breast carcinoma with unusual morphological features are reported. The ages of the female patients ranged from 46 to 79 years (mean 60.5). All tumours had areas typical of an adenomyoepithelioma. In three cases adenomyoepithelioma gradually merged with low-grade adenosquamous carcinoma. In the other three patients a sarcomatoid carcinoma was associated with adenomyoepithelial areas, A common origin is proposed for these neoplasms, which extends the morphological spectrum of epi-myoepithelial cell tumours.

Extensive and complex defects of the head and neck involving multiple anatomical and functional subunits are a reconstructive challenge. The purpose of this study is to elucidate the reconstructive indications of the use of simultaneous... more

Extensive and complex defects of the head and neck involving multiple anatomical and functional subunits are a reconstructive challenge. The purpose of this study is to elucidate the reconstructive indications of the use of simultaneous double free flaps in head and neck oncological surgery. This is a retrospective review of 21 consecutive cases of head and neck malignancies treated surgically with resection and reconstruction with simultaneous use of double free flaps. Nineteen of 21 patients had T4 primary tumor stage. Eleven patients had prior history of radiotherapy or chemo-radiotherapy. Forty-two free flaps were used in these patients. The predominant combination was that of free fibula osteo-cutaneous flap with free anterolateral thigh (ALT) fascio-cutaneous flap. The indications of the simultaneous use of double free flaps can be broadly classified as: (a) large oro-mandibular bone and soft tissue defects (n 5 13), (b) large oro-mandibular soft tissue defects (n 5 4), (c) complex skull-base defects (n 5 2), and (d) dynamic total tongue reconstruction (n 5 2). Flap survival rate was 95%. Median follow-up period was 11 months. Twelve patients were alive and free of disease at the end of the follow-up. Eighteen of 19 patients with oro-mandibular and glossectomy defects were able to resume an oral diet within two months while one patient remained gastrostomy dependant till his death due to disease not related to cancer. This patient had a combination of free fibula flap with free ALT flap, for an extensive oro-mandibular defect. The associated large defect involving the tongue accounted for the swallowing difficulty. Simultaneous use of double free flap aided the reconstruction in certain large complex defects after head and neck oncologic resections. Such combination permits better complex multiaxial subunit reconstruction. An algorithm for choice of flap combination for the appropriate indications is proposed. V V

El carcinoma adenoideo quístico es la neoplasia maligna de glándulas salivales menores más frecuente (76.5%), se caracteriza clínicamente por ser de crecimiento lento, la localización más frecuente es el paladar duro. Histopatológicamente... more

El carcinoma adenoideo quístico es la neoplasia maligna de glándulas salivales menores más frecuente (76.5%), se caracteriza clínicamente por ser de crecimiento lento, la localización más frecuente es el paladar duro. Histopatológicamente presenta tres patrones, cribiforme, tubular y sólido; el tipo sólido esta relacionado con un pobre pronóstico a diferencia del tipo cribiforme que tiene un mejor pronóstico. El tratamiento de elección es la excisión quirúrgica con márgenes amplios y cuando existe metástasis a nódulos linfáticos está indicada la radioterapia posquirúrgica. Se presenta el caso clínico de un hombre de 19 años de edad con recidiva de lesión en dorso de lengua y diagnóstico previo de adenoma monomorfo. En la segunda biopsia se diagnostica como carcinoma adenoideo quístico, por lo que probablemente hubo un error en el diagnóstico original, se decide usar inmunohistoquímica: CALP, CEA, Antígeno Epitelial de Membrana, Proteína Ácido Fibrilar Glial, Ki67, las cuales se observaron positivas en diferentes intensidades, lo que corroboró el diagnóstico de carcinoma adenoideo quístico. El paciente presentó recidiva después de 2 años.

Objectives. This study aimed to investigate the diverse histopathological types and distribution characteristics of epithelial minor salivary gland tumors (MSGTs) in a Chinese population. Study design. We conducted a descriptive... more

Objectives. This study aimed to investigate the diverse histopathological types and distribution characteristics of epithelial minor salivary gland tumors (MSGTs) in a Chinese population. Study design. We conducted a descriptive demographic study of 737 intraoral MSGTs in patients in southwest China from 1990 to 2004. Results. A total of 737 epithelial MSGTs, consisting of 340 (46.1%) benign and 397 (53.9%) malignant tumors, were confirmed in 381males and 356 females. The average age of patients with benign and malignant tumors was 40.7 and 49.4 years, respectively. The palate was the most commonly affected site (67.4%). Pleomorphic adenoma (PA) (81.8%) and adenoid cystic carcinoma (ACC) (36.0%) were the most frequent types in benign and malignant tumors, respectively.

Primary central salivary gland carcinomas of the mandible are uncommon neoplasms. Consequently, their proper diagnosis is often in doubt. We retrospectively studied the cases of 16 patients treated at The University of Texas M. D.... more

Primary central salivary gland carcinomas of the mandible are uncommon neoplasms. Consequently, their proper diagnosis is often in doubt. We retrospectively studied the cases of 16 patients treated at The University of Texas M. D. Anderson Cancer Center and the Institut Gustave Roussy from 1950 to 1990. Patients ranged in age from 24 to 76 years (mean, 51 years). Nine patients were women and seven were men. Each case involved either the angle or the posterior body of the mandible. Swelling, pain, and trismus were the most frequent complaints. For all patients, radiography revealed a cystic defect resembling an osteolytic odontogenic lesion or metastasis. Five histologic types of carcinoma were diagnosed: seven cases of mucoepidermoid carcinoma (five low-grade and two high-grade), four cases of adenoid cystic carcinoma, two cases of adenocarcinoma, two cases of acinic-cell carcinoma, and one case of epithelial-myoepithelial carcinoma. All patients were treated with wide surgical excision. Eight patients received postoperative irradiation. Five patients with low-grade mucoepidermoid carcinoma, two with acinic-cell carcinoma, and one with epithelial-myoepithelial carcinoma were free of disease 2 to 15 years after initial treatment (mean, 6.2 years). Two patients with adenoid cystic carcinoma are living with lung metastasis. The remaining six patients died of their carcinomas within 4 years after initial treatment. Because of their unique morphology and clinical behavior, these tumors should be distinguished from other intraosseous neoplasms of the mandible, including those with clear-cell patterns.

Epidermal growth factor receptor (EGFR) is highly expressed in adenoid cystic carcinoma (ACC). The efficacy and toxicity of cetuximab with concomitant platinum-based chemoradio- or chemotherapy in patients with locally advanced or... more

Epidermal growth factor receptor (EGFR) is highly expressed in adenoid cystic carcinoma (ACC). The efficacy and toxicity of cetuximab with concomitant platinum-based chemoradio- or chemotherapy in patients with locally advanced or metastatic ACC, respectively, was evaluated. Eligible patients (9 with locally advanced tumour and 12 with metastases) had positive tumour EGFR expression. The cetuximab loading dose (400 mg m⁻²) was followed by 250 mg m⁻² per week. Locally advanced tumours were irradiated (mean dose 65 Gy) and treated with concomitant cisplatin (75 mg m⁻², intravenously). Patients with metastases received concomitant cisplatin and 5-fluorouracil (4 × 1000 mg m⁻²). For patients with locally advanced disease (median follow-up: 52 months), the median progression-free survival (PFS) was 64 months and the 2-year overall survival (OS) rate was 100%. For patients with metastases (median follow-up: 72 months), the median PFS and OS were 13 and 24 months, respectively. In both gro...

Objectives: Tracheal sleeve pneumonectomy, although technically demanding, is considered the choice for tracheobronchial angle cancers. Complications in our 49 tracheal sleeve pneumonectomies are reviewed. Results, complications, and... more

Objectives: Tracheal sleeve pneumonectomy, although technically demanding, is considered the choice for tracheobronchial angle cancers. Complications in our 49 tracheal sleeve pneumonectomies are reviewed. Results, complications, and technical aspects are critically discussed. Although series in the literature differ in selection of patients and surgical techniques and extend over long periods, we attempt to compare our experience with results from the literature.

Sein ; Carcinome adénoïde kystique ; Traitement ; Pronostic Résumé Le carcinome adénoïde kystique (CAK) du sein est une tumeur rare qui représente moins de 1 % des cancers mammaires. Le pronostic est meilleur par rapport à celui des... more

Sein ; Carcinome adénoïde kystique ; Traitement ; Pronostic Résumé Le carcinome adénoïde kystique (CAK) du sein est une tumeur rare qui représente moins de 1 % des cancers mammaires. Le pronostic est meilleur par rapport à celui des autres cancers mammaires. Les auteurs rapportent un cas de CAK du sein chez une patiente âgée de 57 ans ayant consulté pour un nodule du quadrant supéro-externe du sein droit associé à des mastodynies. La tumeur a été classée cT3N0M0 selon TNM 2002. La patiente a bénéficié d'une biopsie exérèse avec étude extemporanée et le geste chirurgical a été complété par une mastectomie avec curage ganglionnaire axillaire homolatéral. L'étude anatomopathologique et immuno-histochimique de la pièce opératoire a confirmé le diagnostic de CAK sans expression des récepteurs hormonaux, ni amplification de l'Her-2-neu, la tumeur a ainsi été classée pT3N-M0. Une radiothérapie externe adjuvante de la paroi droite a été réalisée à la dose de 50 Gy. Après un recul de 24 mois, la patiente est en rémission complète maintenue. Le CAK du sein est un carcinome de bon pronostic, malgré son phénotype triple négatif. Vu la rareté de cette tumeur, sa prise en charge thérapeutique est encore mal établie.

Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm. We report two observations occurring in female patients, 54 and 65 years old, who consulted for a mastodynia. Clinical examination showed limited painful breast nodules. On... more

Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm. We report two observations occurring in female patients, 54 and 65 years old, who consulted for a mastodynia. Clinical examination showed limited painful breast nodules. On ultrasound and mammography they are well-limited bulky mass without microcalcifications. Diagnosis was based on final histopathological exam completed by immunohistochemistry or after slides review. The two patients were treated by mammectomy plus adjuvant radiotherapy and remain alive in remission with a follow-up of 29 and 36 months.