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Tamagawa K, Otsuki N, Shimoda H, Morita N, Furukawa T, Teshima M, Shinomiya H, Nibu KI. Incidence and spread pattern of lymph node metastasis from submandibular gland cancer. Eur Arch Otorhinolaryngol 2023; 280:4233-4238. [PMID: 37212862 PMCID: PMC10382349 DOI: 10.1007/s00405-023-08020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES To clarify the indication of neck dissection (ND) for patient with submandibular gland (SMG) cancer. METHODS A total of 43 patients with SMG cancer were retrospectively analyzed. Forty-one patients underwent ND: Levels I-V in 19 patients, Levels I-III in 18 patients, and Level Ib in 4 patients. The other two patients did not undergo ND, since preoperative diagnoses were benign. Postoperative radiotherapy was performed in 19 patients with positive surgical margin, high grade cancer or stage IV disease. RESULTS LN metastases were pathologically confirmed in all patients with cN + and 6 out of 31 patients with cN-. No patients developed regional recurrence during follow-up periods. Ultimately, LN metastases were pathologically confirmed in 17 of 27 high grade, one out of 9 intermediate grade, but not in 7 low grade. CONCLUSIONS Prophylactic neck dissection should be considered in T3/4 and high grade SMG cancers.
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Affiliation(s)
- Kotaro Tamagawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan.
- Department of Otolaryngology-Head and Neck Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan.
| | - Hikari Shimoda
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Naruhiko Morita
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
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Cantù G. Adenoid cystic carcinoma. An indolent but aggressive tumour. Part B: treatment and prognosis. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2021; 41:296-307. [PMID: 34533533 PMCID: PMC8448184 DOI: 10.14639/0392-100x-n1729] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/03/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Giulio Cantù
- Former Director of Otorhinolaryngology and Cranio-Maxillo-Facial Unit, Fondazione I.R.C.C.S. Istituto Nazionale dei Tumori, Milano, Italy
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The incidence of occult metastasis and the status of elective neck dissection in salivary adenoid cystic carcinoma: a single center study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:516-519. [DOI: 10.1016/j.oooo.2018.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/20/2017] [Accepted: 01/20/2018] [Indexed: 11/23/2022]
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Ni Q, Sun J, Ma C, Li Y, Ju J, Sun M. The Neuropilins and Their Ligands in Hematogenous Metastasis of Salivary Adenoid Cystic Carcinoma-An Immunohistochemical Study. J Oral Maxillofac Surg 2017; 76:569-579. [PMID: 28961428 DOI: 10.1016/j.joms.2017.08.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE We investigated the expression of neuropilin-1 (NRP1), neuropilin-2 (NRP2), vascular endothelial growth factor-A (VEGF-A), semaphorin-3A (Sema-3A), and semaphorin-3F (Sema-3F) in normal salivary gland (NSG) tissue, nonmetastatic salivary adenoid cystic carcinoma (SACC), and metastatic SACC to better understand their role in intratumoral angiogenesis and hematogenous metastasis of SACC. PATIENTS AND METHODS The study included 60 SACC patients, equally divided between nonmetastatic SACC and metastatic SACC. We used 30 NSG samples as the control. The expression of cytokines was studied by immunohistochemistry and compared using the integrated optical density. The relationship between NRP1, NRP2, VEGF-A, and Sema-3A expression and microvessel density (MVD) was analyzed in the 3 groups. RESULTS In metastatic SACC, the expression levels of NRP1 and VEGF-A were significantly greater than those in nonmetastatic SACC and NSG. The expression of Sema-3A and Sema-3F was significantly lower in metastatic SACC than that in nonmetastatic SACC and NSG (P < .0001). No significant differences were found in NRP2 expression among the 3 groups (P = .43). The MVD of metastatic SACC was significantly greater than that of nonmetastatic SACC and NSG (P < .0001). However, the lymphatic vessel density of the 3 groups was not significantly different statistically. The relationship between MVD and NRP1 or VEGF-A showed a significant positive correlation (P < .0001, for both). However, a significant negative correlation was found between the MVD and Sema-3A or Sema-3F expression (P < .0001, for both). CONCLUSIONS Hematogenous metastasis of SACC is correlated with high expression of NRP1 and VEGF-A and low expression of Sema-3A and Sema-3F. The increased numbers of microvessels induced by VEGF-A signaling, combined with NRP1, could be one of the key reasons leading to the enhanced hematogenous metastasis in SACC.
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Affiliation(s)
- Qianwei Ni
- Resident, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; and Department of Oral and Maxillofacial Surgery, General Hospital of Xinjiang Military Region, Urumqi, People's Republic of China
| | - Jinlong Sun
- Resident, Department of Stomatology, Navy General Hospital, Beijing, People's Republic of China
| | - Chao Ma
- Resident, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Yun Li
- Resident, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Jun Ju
- Resident, Center of Otolaryngology of PLA, Navy General Hospital, Beijing, People's Republic of China
| | - Moyi Sun
- Professor, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China.
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Clinical outcomes and prognostic factors of salivary gland adenoid cystic carcinomas: a case control study. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:531-535. [DOI: 10.1016/j.oooo.2016.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/08/2016] [Accepted: 11/25/2016] [Indexed: 12/19/2022]
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Cervical lymph node metastasis in adenoid cystic carcinoma of the major salivary glands. The Journal of Laryngology & Otology 2016; 131:96-105. [DOI: 10.1017/s0022215116009749] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AbstractObjective:To verify the prevalence of cervical lymph node metastasis in adenoid cystic carcinoma of major salivary glands, and to establish recommendations for elective neck treatment.Methods:A search was conducted of the US National Library of Medicine database. Appropriate articles were selected from the abstracts, and the original publications were obtained to extract data.Results:Among 483 cases of major salivary gland adenoid cystic carcinoma, a total of 90 (18.6 per cent) had cervical metastasis. The prevalence of positive nodes from adenoid cystic carcinoma was 14.5 per cent for parotid gland, 22.5 per cent for submandibular gland and 24.7 per cent for sublingual gland. Cervical lymph node metastasis occurred more frequently in patients with primary tumour stage T3–4 adenoid cystic carcinoma, and was usually located in levels II and III in the neck.Conclusion:Adenoid cystic carcinoma of the major salivary glands is associated with a significant prevalence of cervical node metastasis, and elective neck treatment is indicated for T3 and T4 primary tumours, as well as tumours with other histological risk factors.
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Sali PA, Yadav KS, Bushan K, Rajpurohit V, Varty PP, Sharma S. A rare case of lacrimal adenoid cystic carcinoma with large hepatic and multiple pulmonary metastases with successful surgical treatment. Int J Surg Case Rep 2016; 20:151-4. [PMID: 26866882 PMCID: PMC5037288 DOI: 10.1016/j.ijscr.2016.01.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Adenoid cystic carcinoma (ACC) of the lacrimal gland is rare but with high recurrence rates and late metastases. They occasionally metastasise via haematogenous spread to lungs, brain and bone. Liver is a rare site of metastasis and is usually present with disseminated disease. PRESENTATION OF CASE A 42 year old lady, a known case of adenoid cystic carcinoma of the lacrimal gland who had been operated 4 years ago for the same followed by chemotherapy and radiotherapy. She was detected with large hepatic and bilateral multiple pulmonary metastases. A right hepatectomy was done. After six months when her general condition improved we did a staged pulmonary metastatectomy. Histology confirmed the diagnosis. She is presently doing well with no recurrence since 18 months. DISCUSSION Usually asymptomatic, the commonest symptom is pain. It is a locally invasive disease with a poor prognosis if detected late. Surgery is the only proven therapy. Isolated hepatic metastases being managed surgically has been reported. However, extensive, staged, surgical resection of hepatic and pulmonary metastases has not been reported. CONCLUSION Lacrimal ACC is an aggressive tumour with known late metastases with the liver being affected seldomly. Our case highlights that even disseminated metastases to the liver and the lungs from lacrimal ACC can be managed surgically with a good outcome. To our knowledge, no such report with distant metastases to the liver and the lung along with their successful surgical management has been reported.
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Affiliation(s)
- Priyanka Akhilesh Sali
- Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Kamal Sunder Yadav
- Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Kirti Bushan
- Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Virendra Rajpurohit
- Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Paresh Pramod Varty
- Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Sanjay Sharma
- Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
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Uppada U, Jadhav P, Paul D. Adenoid cystic carcinoma mimicking benign mucosal cyst of maxillary sinus. JOURNAL OF DENTAL RESEARCH AND REVIEW 2016. [DOI: 10.4103/2348-2915.184219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Shum JW, Chatzistefanou I, Qaisi M, Lubek JE, Ord RA. Adenoid cystic carcinoma of the minor salivary glands: a retrospective series of 29 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:210-4. [PMID: 26686954 DOI: 10.1016/j.oooo.2015.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 10/06/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Approximately 78% of minor salivary gland tumors are malignant, of which adenoid cystic carcinoma (ACC) represents 15% in our series. ACC is an uncommon tumor characterized by slow growth and a high potential for recurrence. This series of 29 consecutive patients examines clincopathologic features, management, and survival outcomes. MATERIALS AND METHODS This study is a retrospective chart review of 29 patients with ACC of the minor salivary glands in a period of 23 years (1989 and 2012). RESULTS The mean age was 61.2 years (16-89 years), with no gender predilection. The majority occurred in the palate/maxilla (66%) and initial presentation was stage IV. Mean follow-up was 42.6 months. Recurrence rate was 10% local, 14% distant over the observation period. CONCLUSIONS The palate/maxilla is the preferred location for occurrence, and initial presentation at stage IV is common. Postoperative radiation remains a common strategy to prevent local recurrence in lesions with adverse features.
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Affiliation(s)
- Jonathan W Shum
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center, Houston, TX, USA.
| | - Ioannis Chatzistefanou
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Greece
| | - Mohammed Qaisi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Mississippi, Jackson, MS, USA
| | - Joshua E Lubek
- Assistant Professor and Fellowship Director Oral, Head and Neck Surgery/Microvascular Surgery, Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry and Greenebaum Cancer Center, Baltimore, MD, USA
| | - Robert A Ord
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry and Greenebaum Cancer Center, Baltimore, MD, USA
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Kumar V, Nair R, Upadhyaya S, Nayal B, Shetty A. Extradural Spinal Metastasis of Adenoid Cystic Carcinoma (ACC): A Case Report. J Clin Diagn Res 2015; 9:XD09-XD10. [PMID: 25738073 DOI: 10.7860/jcdr/2015/10644.5498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/11/2014] [Indexed: 11/24/2022]
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant tumour of the major salivary glands. It accounts for 10-15% of all salivary gland tumours and 1% of all head and neck tumours. Surgical resection followed by radiation is the choice of treatment for ACC. However, late loco-regional recurrence and metastasis is often seen emphasizing the importance of long-term follow-up. We report an unusual case of extradural metastasis of ACC in the dorsal spine. The primary submandibular gland tumour was resected 11 y back. A recurrence had been detected two years prior to the occurrence of spinal metastasis. Surgical decompression was done which was followed by palliative radiotherapy. Patient is symptomatically better, ambulant and on regular follow-up.
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Affiliation(s)
- Vinod Kumar
- Assistant Professor, Department of Neurosurgery, Kasturba Hospital , Manipal, India
| | | | - Sunil Upadhyaya
- Assistant Professor, Department of Pathology, Kasturba Hospital , Manipal, India
| | - Bhavna Nayal
- Assistant Professor, Department of Pathology, Kasturba Hospital , Manipal, India
| | - Arjun Shetty
- Professor and HOD, Department of Neurosurgery, Kasturba Hospital , Manipal, India
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Pushpanjali M, Sujata DN, Subramanyam SB, Jyothsna M. Adenoid cystic carcinoma: An unusual presentation. J Oral Maxillofac Pathol 2014; 18:286-90. [PMID: 25328314 PMCID: PMC4196302 DOI: 10.4103/0973-029x.140796] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 07/09/2014] [Indexed: 11/20/2022] Open
Abstract
The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial regions. Peak incidence occurs between the 5th and 6th decades of life. The clinical and pathological findings typical of this tumor include slow growth, peri-neural invasion, multiple local recurrences and distant metastasis. Herein, we report a case of adenoid cystic carcinoma of oropharynx with unusual clinical presentation. The diagnosis of this case and importance of cytology in diagnosing such cases is discussed.
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Affiliation(s)
- M Pushpanjali
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Rajiv Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India
| | - D Naga Sujata
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Rajiv Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India
| | - S Bala Subramanyam
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Rajiv Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India
| | - M Jyothsna
- Department of Oral Pathology, Government Dental College and Hospital, Rajiv Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India
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Chundru NSV, Amudala R, Thankappan P, Nagaraju CD. Adenoid cystic carcinoma of palate: A case report and review of literature. Dent Res J (Isfahan) 2013; 10:274-8. [PMID: 23946749 PMCID: PMC3731973 DOI: 10.4103/1735-3327.113372] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Adenoid cystic carcinoma is an uncommon, slow growing malignant salivary gland tumor that is characterized by wide local infiltration, perineural spread, propensity to local recurrence and distant metastasis. In this paper, the authors present a case of adenoid cystic carcinoma affecting the palate and involving the maxillary sinus in a 60-year-old male patient along with a brief review of literature.
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Affiliation(s)
- Naga Sirisha Venkata Chundru
- Department of Oral and Maxillofacial Pathology, C.K.S. Theja Institute of Dental Sciences and Research, Chadalawada Nagar, Renigunta Road, Tirupathi, India
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Dutta NN, Baruah R, Das L. Adenoid cystic carcinoma - Clinical presentation and cytological diagnosis. Indian J Otolaryngol Head Neck Surg 2012; 54:62-4. [PMID: 23119858 DOI: 10.1007/bf02911012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Adenoid cystic carcinoma is a tumor arising from the minor salivary glands, the palate being the commonest site. It accounts for about 1% of all head and neck malignancies. We report a case with the typical presentation of a palatal growth with extensive intra-cranial invasion. The diagnosis of this case and a brief review of literature is discussed. Final diagnosis of this case was made from cytological reports. The dry smears stained with MGG were found to be definitely superior to the alcohol fixed slides stained with papanicolaou. The aim here is to highlight the importance of cytology in the diagnosis of such tumors.
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Min R, Siyi L, Wenjun Y, Ow A, Lizheng W, Minjun D, Chenping Z. Salivary gland adenoid cystic carcinoma with cervical lymph node metastasis: a preliminary study of 62 cases. Int J Oral Maxillofac Surg 2012; 41:952-7. [PMID: 22647764 DOI: 10.1016/j.ijom.2012.04.023] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 03/02/2012] [Accepted: 04/26/2012] [Indexed: 11/26/2022]
Abstract
Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm that originates most commonly in the major and minor salivary glands of the head and neck region. This study provides new information on head and neck ACC with cervical lymph node metastasis. Of 616 patients who underwent primary tumour resection from 1995 to 2008 in the authors' hospital, 62 cases with cervical lymph node metastasis were analyzed. The general incidence of cervical lymph node metastasis in ACC was approximately 10%. The base of tongue, mobile tongue and mouth floor were the most frequent sites of lymph nodes metastasis, with incidences of 19.2%, 17.6% and 15.3%, respectively. Most cases occurred via a classic 'tunnel-style' metastasis and the level Ib and II regions were the most frequently involved. Primary site and lymphovascular invasion were significantly associated with lymph node metastasis. High patient mortality was significantly correlated with lymph node positive cases. The tongue-mouth floor complex has a high propensity for cervical lymph node metastasis, which occurs through a classic 'tunnel-style' metastasis. Peritumoral lymphovascular invasion could be taken as strong predictor for lymph node metastasis, which ultimately leads to poor prognosis of ACC patient. Selective neck dissection should be considered in such cases.
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Affiliation(s)
- R Min
- Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomotology, PR China
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Khanfir K, Kallel A, Villette S, Belkacémi Y, Vautravers C, Nguyen T, Miller R, Li YX, Taghian AG, Boersma L, Poortmans P, Goldberg H, Vees H, Senkus E, Igdem S, Ozsahin M, Jeanneret Sozzi W. Management of adenoid cystic carcinoma of the breast: a Rare Cancer Network study. Int J Radiat Oncol Biol Phys 2011; 82:2118-24. [PMID: 21570212 DOI: 10.1016/j.ijrobp.2010.12.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 11/24/2010] [Accepted: 12/08/2010] [Indexed: 01/11/2023]
Abstract
BACKGROUND Mammary adenoid cystic carcinoma (ACC) is a rare breast cancer. The aim of this retrospective study was to assess prognostic factors and patterns of failure, as well as the role of radiation therapy (RT), in ACC. METHODS Between January 1980 and December 2007, 61 women with breast ACC were treated at participating centers of the Rare Cancer Network. Surgery consisted of lumpectomy in 41 patients and mastectomy in 20 patients. There were 51(84%) stage pN0 and 10 stage cN0 (16%) patients. Postoperative RT was administered to 40 patients (35 after lumpectomy, 5 after mastectomy). RESULTS With a median follow-up of 79 months (range, 6-285), 5-year overall and disease-free survival rates were 94% (95% confidence interval [CI], 88%-100%) and 82% (95% CI, 71%-93%), respectively. The 5-year locoregional control (LRC) rate was 95% (95% CI, 89%-100%). Axillary lymph node dissection or sentinel node biopsy was performed in 84% of cases. All patients had stage pN0 disease. In univariate analysis, survival was not influenced by the type of surgery or the use of postoperative RT. The 5-year LRC rate was 100% in the mastectomy group versus 93% (95% CI, 83%-100%) in the breast-conserving surgery group, respectively (p = 0.16). For the breast-conserving surgery group, the use of RT significantly correlated with LRC (p = 0.03); the 5-year LRC rates were 95% (95% CI, 86%-100%) for the RT group versus 83% (95% CI, 54%-100%) for the group receiving no RT. No local failures occurred in patients with positive margins, all of whom received postoperative RT. CONCLUSION Breast-conserving surgery is the treatment of choice for patients with ACC breast cancer. Axillary lymph node dissection or sentinel node biopsy might not be recommended. Postoperative RT should be proposed in the case of breast-conserving surgery.
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Human Papillomavirus-associated Squamous Cell Carcinoma of the Upper Aerodigestive Tract. Am J Surg Pathol 2010; 34:e15-24. [DOI: 10.1097/pas.0b013e3181e21478] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Papadogeorgakis N, Kalfarentzos EF, Vourlakou C, Malta F, Exarhos D. Simultaneous pleomorphic adenoma of the left parotid gland and adenoid cystic carcinoma of the contralateral sublingual salivary gland: a case report. Oral Maxillofac Surg 2009; 13:221-224. [PMID: 19690903 DOI: 10.1007/s10006-009-0168-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Sublingual salivary gland neoplasms are extremely rare, accounting for only 0.3-1% of all epithelial salivary gland tumors. Most of the sublingual tumors are malignant, adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC) being the most common histological types. The coexistence of two salivary gland tumors located in different major salivary glands is uncommon. CASE REPORT A rare case of two simultaneous tumors of the major salivary glands, one in the sublingual and the other in the contralateral parotid gland in a female patient is reported. DISCUSSION The diagnostic procedure followed, and the management of the patient, is outlined in the paper.
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Affiliation(s)
- Nick Papadogeorgakis
- Department of Oral and Maxillofacial Surgery, Evangelismos General Hospital, Dental School, University of Athens, Athens, Greece
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Muller A, Sonkoly E, Eulert C, Gerber PA, Kubitza R, Schirlau K, Franken-Kunkel P, Poremba C, Snyderman C, Klotz LO, Ruzicka T, Bier H, Zlotnik A, Whiteside TL, Homey B, Hoffmann TK. Chemokine receptors in head and neck cancer: association with metastatic spread and regulation during chemotherapy. Int J Cancer 2006; 118:2147-57. [PMID: 16331601 DOI: 10.1002/ijc.21514] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Head and neck carcinomas are histologically and clinically heterogeneous. While squamous cell carcinomas (SCC) are characterized by lymphogenous spread, adenoid cystic carcinomas (ACC) disseminate preferentially hematogenously. To study cellular and molecular mechanisms of organ-specific metastasis, we used SCC and ACC cell lines and tumor tissues, obtained from patients with primary or metastatic disease. Comprehensive analysis at the mRNA and protein level of human chemokine receptors showed that SCC and ACC cells exhibited distinct and nonrandom expression profiles for these receptors. SCC predominantly expressed receptors for chemokines homeostatically expressed in lymph nodes, including CC chemokine receptor (CCR) 7 and CXC chemokine receptor (CXCR)5. No difference in expression of chemokine receptors was seen in primary SCC and corresponding lymph node metastases. In contrast to SCC, ACC cells primarily expressed CXCR4. In chemotaxis assays, ACC cells were responsive to CXCL12, the ligand for CXCR4. Exposure of ACC cells to cisplatin resulted in upregulation of CXCR4 on the cell surface, which was repressed by the transcriptional inhibitor, alpha-amanitin. Treatment of ACC cells with CXCL12 resulted in the activation of Akt and ERK1/2 pathways. Furthermore, CXCL12 suppressed the rate of apoptosis induced by cisplatin in ACC cells, suggesting that signaling via CXCR4 may be part of a tumor cell survival program. Discrimination of the chemokine receptor profile in SCC and ACC in vitro and in tissues provided insights into their distinct biologic and clinical characteristics as well as indications that chemokine receptors might serve as future therapeutic targets in these malignancies.
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Affiliation(s)
- Anja Muller
- Department of Radiation Oncology, Heinrich-Heine-University, Duesseldorf, Germany.
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van der Wal JE, Becking AG, Snow GB, van der Waal I. Distant metastases of adenoid cystic carcinoma of the salivary glands and the value of diagnostic examinations during follow-up. Head Neck 2002; 24:779-83. [PMID: 12203804 DOI: 10.1002/hed.10126] [Citation(s) in RCA: 187] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) accounts for approximately 10% of all neoplasms of the salivary glands. Late distant metastases and local recurrences are responsible for a rather low long-term survival rate. AIM To study the metastasizing pattern of ACC of the salivary glands in 51 patients. METHOD Fifty-one patients with an ACC in the intraoral/sublingual salivary glands (n = 30), parotid gland (n = 8), submandibular gland (n = 2), maxillary sinus (n = 6), and nasal cavity (n = 5) have been studied. The male-female ratio was 1:1, the mean age was 54.3 (range, 19-81) years. In 30 cases treatment consisted of surgery and radiotherapy. In 13 cases surgery alone was carried out. The average follow-up time was 117.8 (range, 1-171) months. RESULTS In 28 cases (54.9%) distant metastases occurred, and in 3 patients (5.8%) regional lymph node metastases occurred. In 12 of the 28 patients with distant metastases (42.8%), only the lungs were involved, whereas in 5 of the 28 patients (17.8%), the distant metastases occurred in other organs (eg, bones and brain). In 11 of the 28 patients (39.2%) metastases were found both in the lungs and other organs. Twenty-four of the 51 patients (47.0%) died because of their tumor. The average time between the occurrence of lung metastases and death was 32.3 months and between the occurrence of metastases elsewhere and death 20.6 months. CONCLUSION Distant metastases of ACC of the salivary glands occur most often in the lungs. Although these lung metastases are the first to occur, these patients die later than patients with distant metastases in other organs. The value of annual chest films or other tests for the presence of distant metastases during follow-up after surgical removal of an ACC seems rather questionable.
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Affiliation(s)
- Jacqueline E van der Wal
- Department of Oral & Maxillofacial Surgery/Oral Pathology, VU Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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20
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Mehrotra R, Singh M. Diagnosis of hepatic metastasis of adenoid cystic carcinoma of the salivary gland by fine needle aspiration. Cytopathology 1999; 10:216-7. [PMID: 10390072 DOI: 10.1046/j.1365-2303.1999.0157a.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Kim GE, Park HC, Keum KC, Lee CG, Suh CO, Hur WJ, Kim KM, Hong WP. Adenoid cystic carcinoma of the maxillary antrum. Am J Otolaryngol 1999; 20:77-84. [PMID: 10203156 DOI: 10.1016/s0196-0709(99)90015-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate characteristic clinical features and outcome for patients with adenoid cystic carcinoma (ACC) of the maxillary antrum. PATIENTS AND METHODS Twenty-two patients with ACC of the maxillary antrum were initially treated with surgery alone (3 patients), radiation alone (9 patients), or a combination of surgery and radiation (10 patients). Salvage treatment for initial failure was individualized. Patterns of failure, survival, and prognostic factors were retrospectively analyzed. RESULTS The most frequent site of failure was local recurrence at the primary site (72.7%). All patients treated with either surgery alone or radiation alone experienced one or more local recurrences, whereas patients who received planned combined surgery and radiation had a much lower local recurrence rate (40%). Neck node failure (4.6%) was an uncommon event, whereas distant metastases were clinically documented in seven patients (32%). Most of the treatment failures appeared within 5 years, but treatment failures after 5 years were not uncommon. The overall survival and disease-free survival rates at 10 years were 37.6% and 13.6%, respectively. Clinicopathological factors, such as location of primary tumor, tumor stage, and histological grade were of no value in predicting a favorable survival. The significant prognostic factors influencing 10-year survival were the pathological finding of perineural invasion and the initial mode of treatment. CONCLUSION ACC of the maxillary antrum represented a unique natural history characterized by a more aggressive tumor behavior and an unfavorable prognosis. Combined surgery and radiotherapy is recommended for optimal local control and survival.
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Affiliation(s)
- G E Kim
- Department of Radiation Oncology, Yonsei University, College of Medicine, Seoul, Korea
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22
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Spiers AS, Esseltine DL, Ruckdeschel JC, Davies JN, Horton J. Metastatic Adenoid Cystic Carcinoma of Salivary Glands: Case Reports and Review of the Literature. Cancer Control 1996; 3:336-342. [PMID: 10765225 DOI: 10.1177/107327489600300405] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Adenoid cystic carcinoma is an uncommon tumor of the salivary gland. Little has been published on the chemotherapy of this neoplasm. METHODS: The literature on this disease is reviewed, and data from seven unpublished cases are presented. RESULTS: Four patients received cyclophosphamide. One responded, and another had pain relief. The literature review did not identify any single drug or combination that might be regarded as the treatment of choice. CONCLUSIONS: Systematic, multi-institutional studies are required to determine appropriate systemic treatment for metastatic adenoid cystic carcinoma of salivary gland origin.
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Affiliation(s)
- AS Spiers
- Division of Medical Oncology and Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
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23
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Whear NM, Addy JM. Adenoid cystic carcinoma of the sublingual gland--an unusual presentation. Br J Oral Maxillofac Surg 1993; 31:113-6. [PMID: 8385987 DOI: 10.1016/0266-4356(93)90173-t] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A case of adenoid cystic carcinoma of the sublingual salivary gland presenting as recurrent submandibular salivary gland swelling is described. The obstructive symptoms were due to involvement of the ipsilateral submandibular duct by the tumour. A review of the literature suggests that this is the first such case to be reported. The importance of intra-oral examination when investigating swellings of the neck is emphasised.
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Affiliation(s)
- N M Whear
- Department of Oral and Maxillofacial Surgery, St Thomas' Hospital, London
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Hamper K, Lazar F, Dietel M, Caselitz J, Berger J, Arps H, Falkmer U, Auer G, Seifert G. Prognostic factors for adenoid cystic carcinoma of the head and neck: a retrospective evaluation of 96 cases. J Oral Pathol Med 1990; 19:101-7. [PMID: 2160530 DOI: 10.1111/j.1600-0714.1990.tb00806.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cases of adenoid cystic carcinomas of the salivary (n = 90) and lacrimal glands (n = 6) from the years 1965-1980 were evaluated retrospectively with regard to clinical, epidemiologic and histomorphologic parameters, and in 52 cases, nuclear DNA content was assessed using a single cell scanning cytophotometry procedure in order to determine prognostic factors. Clinical courses were poor with a high incidence of recurrences, hematogenous metastases and deaths from tumor. Histology was related to prognosis, glandular tumors showing a better prognosis than solid ones. Tumor size greater than 4 cm was correlated with an unfavorable clinical course in all cases. Cytophotometry yielded various types of histograms (7 diploid, 10 proliferative, 14 triploid, 19 atypical, 2 tetraploid). Significant correlations were found as to the time of survival, tumors with diploid histograms showing the longest intervals and those with atypical ones the shortest. Although the prognosis of adenoid cystic carcinoma remains poor, cytophotometry can offer additional prognostic information in the individual case.
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Affiliation(s)
- K Hamper
- Institute of Pathology, University Hospital Hamburg-Eppendorf, W.Germany
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Koka VN, Tiwari RM, van der Waal I, Snow GB, Nauta J, Karim AB, Tierie AH. Adenoid cystic carcinoma of the salivary glands: clinicopathological survey of 51 patients. J Laryngol Otol 1989; 103:675-9. [PMID: 2547888 DOI: 10.1017/s0022215100109703] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A clinicopathological study of 51 cases of adenoid cystic carcinoma in the head and neck region seen over a period of 20 years is presented. The correlation between various histological features and their impact on the results is attempted. Longterm results with respect to loco-regional recurrences, distant metastases and survival with various modalities of therapy are presented. Although this is a small series, radical surgery in keeping with the aim of avoiding undue mutilation, thus preserving the quality of life, followed by a full course of radiotherapy has been the mainstay of treatment and the results here presented justify this approach.
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Affiliation(s)
- V N Koka
- Department of Otolaryngology/Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands
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26
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Hemprich A, Schmidseder R. The adenoid cystic carcinoma. Special aspects of its growth and therapy. J Craniomaxillofac Surg 1988; 16:136-9. [PMID: 2838528 DOI: 10.1016/s1010-5182(88)80034-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
In spite of its rare incidence the adenoid cystic carcinoma must be treated with respect because of its hidden malignant character. In 5 out of 21 patients recurrences occurred much longer than 5 years after the first operation. The extension of this tumour along branches of the trigeminal nerve could be well demonstrated in 7 of our patients where we were able to produce histological proof or radiographic evidence. The theory of tumour growth along the "tissue of least resistance" is illustrated by a special case report. As for the therapy, ultra-radical surgery has proved to be the most effective so far, whereas radio- or chemotherapy were only useful as palliative measures.
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Affiliation(s)
- A Hemprich
- Dept. of Maxillofacial Surgery, University of Mainz, W.-Germany
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27
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Stell PM, Cruickshank AH, Stoney P. Adenoid cystic carcinoma presenting as a mass in the neck. J Laryngol Otol 1986; 100:1203-4. [PMID: 3021880 DOI: 10.1017/s0022215100100830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Three of a personal series of 82 patients with adenoid cystic carcinoma presented with a node in the neck. Two of these patients had no discoverable primary tumour. One of the latter died rapidly, and might have had an undisclosed primary tumour in the lung. The other remains well 3 years after radical neck dissection, and it is possible that he had a tumour arising in an aberrant cervical salivary rest.
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28
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Shingaki S, Saito R, Kawasaki T, Nakajima T. Adenoid cystic carcinoma of the major and minor salivary glands. A clinicopathological study of 17 cases. JOURNAL OF MAXILLOFACIAL SURGERY 1986; 14:53-6. [PMID: 3005457 DOI: 10.1016/s0301-0503(86)80259-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Local recurrence and distant metastasis were studied in relation to treatment modality and histological findings in 17 patients with adenoid cystic carcinoma of the major and minor salivary glands. Fifteen patients underwent surgical resection with or without postoperative irradiation and the others were treated by irradiation alone. Local recurrence developed in nine patients (52.9%), mostly within two years of the treatment. Incomplete removal was the major reason for the failure to control the primary lesion. Postoperative irradiation was of value in preventing recurrence in patients who demonstrated microscopic residual disease at the surgical margins, whereas it was not effective if gross residual tumour was recognized. Direct surgical intervention on the tumour tissue could have been the possible cause for the distant metastasis that developed in 10 (58.8%) of the 17 patients. Surgical excision with a wider safety margin than the visibly affected area, followed by postoperative irradiation and chemotherapy was essential to obtain a better prognosis.
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30
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Stell PM, Cruickshank AH, Stoney PJ, McCormick MS. Lymph node metastases in adenoid cystic carcinoma. Am J Otolaryngol 1985; 6:433-6. [PMID: 3002198 DOI: 10.1016/s0196-0709(85)80022-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The clinical characteristics of 76 patients with adenoid cystic carcinoma seen during a 22-year period are described. Lymph node metastases at presentation or later occurred almost exclusively in men, and the five-year rate of "node-free" survival was 62 per cent for men and 95 per cent for women. Node metastases were more common in poorly differentiated tumors, but site and stage of the primary disease did not affect the metastatic rate. Surgery scarcely improved the rate of survival of patients with nodal metastases. The authors were unable to confirm previous observations that embolic nodal metastases at a distance from the primary tumor do not occur.
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31
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Lee YY, Castillo M, Nauert C. Intracranial perineural metastasis of adenoid cystic carcinoma of head and neck. THE JOURNAL OF COMPUTED TOMOGRAPHY 1985; 9:219-23. [PMID: 2990815 DOI: 10.1016/0149-936x(85)90065-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Three cases of intracranial perineural metastasis from adenoid cystic carcinoma of the head and neck are presented. The metastases presented more than 1 year (14 months to 5.5 years) after the primary tumor had been successfully treated without any evidence of local recurrence. Computed tomography of the intracranial metastasis demonstrated well-demarcated, hyperdense, enhancing extraaxial masses indistinguishable from meningioma. An intracranial extraaxial mass lesion with the appearance of a meningioma in a patient with known adenoid cystic carcinoma of the head and neck, regardless of the presence or absence of local recurrence, should be considered as metastasis until proved otherwise.
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32
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Howard DJ, Lund VJ. Reflections on the management of adenoid cystic carcinoma of the nasal cavity and paranasal sinuses. Otolaryngol Head Neck Surg 1985; 93:338-41. [PMID: 2991838 DOI: 10.1177/019459988509300309] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Adenoid cystic carcinoma of the nasal cavity and paranasal sinuses has a unique natural history. It has a propensity for frequent local recurrence and early perineural and hematogenous spread. These factors, together with a complex anatomic situation, make adequate oncologic surgery extremely difficult. The incidence of local recurrence is lower in those patients receiving more radical primary surgery, but the choice between conservative and radical management may not alter prognosis. Indeed, it is doubtful if any patients are cured of this disease.
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34
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Adenocystic carcinoma of subglottis. Indian J Otolaryngol Head Neck Surg 1983. [DOI: 10.1007/bf02992377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
The incidence of neck metastases in adenoid cystic carcinoma of the head and neck is considered low and reported incidence range from 0 to 18%. If tumors of the submaxillary gland are considered separately, the incidence of neck metastases reported ranges from 0 to 100%, with a pooled incidence of 34%, significantly higher (P less than 0.001) than that reported for the parotid gland, which ranges from 0 to 21% with a pooled incidence of 10%. It may be suggested that the high incidence of neck metastases in adenoid cystic carcinoma of the submaxillary gland is due, in some cases, to direct extention of the tumor from the gland to the adjacent nodes or from infiltrated surrounding soft tissues rather than by a classic embolic metastasis. In our series of 10 cases, 4 cases showed lymph node metastases. In 3 of these, slides of the radical neck dissection were available for review and showed direct extension of the tumor from surrounding involved soft tissues, although the possibility of embolic metastasis could not be excluded. In the 3 patients with neck metastases at the time of initial diagnosis, distant metastases also developed early in the course of the disease.
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36
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Adenocystic carcinoma of the mandible. Indian J Otolaryngol Head Neck Surg 1979. [DOI: 10.1007/bf02992231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
This study presents the clinical and pathologic data on 38 patients with adenoid cystic carcinoma. Most of the tumors arose from the major salivary glands or the mucus glands of the upper respiratory tract and oral cavity. The typical biological behavior of these tumors was slow but aggressive local growth despite all therapy, followed by eventual death from local disease and/or metastases. Twenty-eight of the patients have died, 22 from adenoic cystic carcinoma, 3 from postoperative complications, and 3 from intercurrent disease. Of the 10 living patients, 4 have active disease, 2 have no evidence of disease 14 years after diagnosis, and 4 have no evidence of disease but follow-up is less than 5 years. We compared various microscopic features of the tumors, including histologic grading, with prognosis but did not demonstrate a correlation in this small series.
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38
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Batsakis JG, Regezi JA. The pathology of head and neck tumors: salivary glands, part 4. HEAD & NECK SURGERY 1979; 1:340-9. [PMID: 227818 DOI: 10.1002/hed.2890010407] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Adenoid cystic carcinomas and adenocarcinomas of salivary tissues are more plentiful in minor than in major salivary glands. In the latter, they comprise no more than 10% of tumors. In both sites, however, their clinical course is characterized by local aggressiveness, recurrences, and a relatively torpid and protracted course, eventually leading to death. The clinicopathologic aspects of these two lesions form the major part of this report. Their behavior is contrasted with that of the two other lesions presented: heterotopic salivary tissue, which is seldom the site of neoplasia; and necrotizing sialometaplasia, a self-limited disorder that simulates malignancy both clinically and histopathologically.
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