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Ohkubo Y, Okubo T, Asari Y, Matsuzaka Y, Kitaguchi M, Shiota S, Fujita R, Okamoto K, Obata H, Kishida Y, Nagao T. Adenoid cystic carcinoma of the orbit without lacrimal gland involvement and with intracranial extension: A case report. Radiol Case Rep 2024; 19:1068-1072. [PMID: 38229598 PMCID: PMC10789932 DOI: 10.1016/j.radcr.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/02/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024] Open
Abstract
We present a 76-year-old female with a 6-year history of decreased vision in the right eye and right-sided facial neuralgia. She had a T1 isointense and T2 isointense enhancing lesion in the right orbit and the middle cranial fossa on MRI examination. Granulomatous disease or meningioma was suspected, however, after removal, the tumor was identified by pathology as adenoid cystic carcinoma (ACC). The tumor has no radiological and clinical lacrimal grand involvement. ACC shows a slow and indolent growth pattern but is associated with poor long-term outcomes, mainly due to perineural invasion, local control failure, and distant metastasis. This case highlights the importance of a pathologic diagnosis and early intervention in similar presentations.
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Affiliation(s)
- Yu Ohkubo
- Department of Radiology, University Hospital Mizonokuchi, Teikyo University School of Medicine, Kanagawa, Japan
| | - Toshiyuki Okubo
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Yusuke Asari
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Yuki Matsuzaka
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | | | - Saori Shiota
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Richi Fujita
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichiro Okamoto
- Department of Neurosurgery, Tokyo Teishin Hospital, Tokyo, Japan
| | - Hiroto Obata
- Department of Ophthalmology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yukiko Kishida
- Department of Pathology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
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Macri C, Juniat V, Davis G, Selva D. Intraorbital and intracranial extension of adenoid cystic carcinoma without clinical or radiological lacrimal gland involvement. Orbit 2022; 41:797-801. [PMID: 34107855 DOI: 10.1080/01676830.2021.1939731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
Adenoid cystic carcinoma (AdCC) is a rare epithelial neoplasm of the head and neck, most commonly found in the salivary glands. Orbital AdCC is an uncommon clinical entity arising from the lacrimal glands, however primary orbital AdCC has been previously described in a small number of case reports. The exact origin of the neoplasm with uninvolved lacrimal gland in the orbit is unknown, however it may arise from ectopic lacrimal or salivary gland tissue, or extension from nearby epithelial structures. We describe the clinical characteristics, investigations and management of a 55-year-old man presenting with vertical diplopia, found to have left posterior orbital AdCC invading the skull base with intracranial extension involving the inferotemporal fossa, pterygopalatine fossa, left carotid artery, cavernous sinus and temporal lobe dura, without clinical or radiological lacrimal gland involvement or systemic metastases.
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Affiliation(s)
- Carmelo Macri
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
| | - Valerie Juniat
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Garry Davis
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, Australia
- The South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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Elhamid S, Razem B, Slimani F. Extraglandular orbital adenoid cystic carcinoma. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Al Ghulaiga FM, Alkhiary H, AlKhalidi H, Alkatan HM. Adenoid cystic carcinoma of the orbit with bilateral cavernous sinus extension: A case report. Int J Surg Case Rep 2022; 99:107623. [PMID: 36099771 PMCID: PMC9568725 DOI: 10.1016/j.ijscr.2022.107623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction and importance Adenoid cystic carcinoma (ACC) is an uncommon malignant epithelial tumor of the salivary and lacrimal glands. Orbital ACC is rare, originating commonly from the lacrimal gland, with only a few cases reported without lacrimal gland involvement. Deep orbital ACC may be associated with extension into skull base structures, and further intracranial invasion. Case presentation We report a 47-year-old gentleman who presented with insidious onset of bilateral proptosis, left ophthalmoplegia, and loss of vision. Imaging revealed left orbital infiltrative mass with intracranial invasion and bilateral cavernous sinus extension. The lacrimal gland was not involved clinically nor radiologically. Histopathology showed ACC with classical cribriform pattern. There was no evidence of primary source of tumor or metastasis. Discussion ACC of the orbit commonly originates from the lacrimal gland. Only a few cases of orbital ACC without lacrimal gland involvement were found in English literature. Workup for our patient did not reveal a primary source of tumor. Tumor may have risen from ectopic orbital lacrimal gland tissue, extension from non-orbital sites, or through perineural or hematogenous spread. Only one case of bilateral cavernous sinus extension has been previously reported. Treatment for advanced orbital ACC is exenteration in most cases. However, due to the advanced nature of disease in our patient, palliative radiotherapy was the treatment of choice. Conclusion Orbital ACC of non-lacrimal origin is rare and is associated with high morbidity and mortality. Early recognition and treatment are key for preventing organ and life-threatening complications such as advanced intracranial spread. Deep orbital adenoid cystic carcinoma (ACC) is very rare. Orbital ACC cases that are not originating from the lacrimal gland have been reported. Such cases have worse prognosis due to early intracranial invasion. We report the second case of orbital ACC with bilateral cavernous sinus invasion.
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Affiliation(s)
- Faris M Al Ghulaiga
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hattan Alkhiary
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hisham AlKhalidi
- Department of Pathology & Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Hind M Alkatan
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pathology & Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
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GU A, Daigavane S. A Rare Case of Orbital Adenoid Cystic Carcinoma Mimicking as Optic Nerve Glioma. Cureus 2022; 14:e25863. [PMID: 35836445 PMCID: PMC9274972 DOI: 10.7759/cureus.25863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 12/03/2022] Open
Abstract
Adenoid cystic carcinoma is an uncommon epithelial cell tumour that usually originates from glands. They arise from the upper respiratory tract, lungs, mammary glands, and skin, but most commonly from the salivary glands and lacrimal glands. Our article reports a 53-year-old individual presenting with a history of diminution of visual acuity over the past one and a half months, also associated with a right-sided headache and throbbing eye pain not relieved by medication. Examination revealed right axial proptosis, ptosis, and visual acuity of 6/36, right afferent pupillary defect (RAPD), restriction of ocular movements in supraduction, dextroelevation, and abduction. The fellow eye was completely normal. MRI revealed an enhancing lesion in the retrobulbar area of the right orbit indicative of optic nerve glioma of stage 2. The patient underwent orbito-zygomatic craniotomy with subtotal excision of the mass by a neurosurgeon. Following surgery, histopathological examination of the excised tumour revealed features consistent with adenoid cystic carcinoma. On the third post-operative day, the subject's vision improved to counting fingers at 3 metres, and extraocular movements were regained.
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Schwartz TM, Rogg JM, Griffith RC, Migliori ME. Adenoid cystic carcinoma presenting with bilateral orbital extension from the soft palate. Digit J Ophthalmol 2019; 24:1-5. [PMID: 30800005 DOI: 10.5693/djo.02.2018.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Adenoid cystic carcinoma (ACC) is a rare neoplasm of secretory epithelium that most commonly occurs in the fifth and sixth decades of life. It is characterized by high recurrence rates and poor response to chemotherapy, In the orbit, ACC usually presents as a lacrimal gland mass. We describe the rare case of a 70-year-old woman who presented with pain during mastication and bilateral facial numbness in the cranial nerve V2 distribution. She was found to have adenoid cystic carcinoma involving the orbits bilaterally without lacrimal gland involvement and without a clear primary tumor. Imaging suggested that the tumor arose from the soft palate by extension along cranial nerves V2 and V3. The patient was treated with radiation therapy with some degree of radiographic improvement 27 months after diagnosis. This case emphasizes the importance of considering adenoid cystic carcinoma when evaluating orbital tumors sparing the lacrimal gland. We also suggest the possibility of an oropharyngeal source with anterograde intracranial extension in cases of putative primary orbital ACC without lacrimal gland involvement.
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Affiliation(s)
- Tayler M Schwartz
- Warren Alpert Medical School of Brown University, Providence Rhode Island
| | - Jeffrey M Rogg
- Department of Radiology, Rhode Island Hospital, Providence, Rhode Island
| | - Rogers C Griffith
- Department of Pathology, Rhode Island Hospital, Providence Rhode Island
| | - Michael E Migliori
- Department of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island
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Chekhchar M, Jaafari D, Mouzari Y, Atidi H, Messaoudi R, Kriet M, Abouchadi A, Abir B, Nassimsabah T. [Atypical clinical presentation of an orbital cylindroma]. J Fr Ophtalmol 2018; 41:e75-e78. [PMID: 29366592 DOI: 10.1016/j.jfo.2017.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/04/2017] [Accepted: 04/20/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M Chekhchar
- Service d'ophtalmologie, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc.
| | - D Jaafari
- Service d'ophtalmologie, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - Y Mouzari
- Service d'ophtalmologie, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - H Atidi
- Service d'ophtalmologie, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - R Messaoudi
- Service d'ophtalmologie, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - M Kriet
- Service d'ophtalmologie, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - A Abouchadi
- Service de chirurgie maxillo-faciale, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - B Abir
- Service de chirurgie maxillo-faciale, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
| | - T Nassimsabah
- Service de chirurgie maxillo-faciale, hôpital Militaire-Avicenne, avenue Al-Mouqaouama, 4000 Marrakech, Maroc
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Crawford L, Sharma S. Orbital Apex Metastasis from Adenoid Cystic Carcinoma: Acute Loss of Vision and Subsequent Recovery with the Radiation. Cureus 2017; 9:e1869. [PMID: 29383291 PMCID: PMC5777629 DOI: 10.7759/cureus.1869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Orbital apex metastasis from adenoid cystic carcinoma (ACC) is rare. We present a patient with known metastatic ACC presented with a rapidly declining vision with visual acuity oculus dexter (OD) equal to counting fingers at two feet. On imaging, she was found to have a right orbital apex tumor causing compressive optic neuropathy. She received the intensity modulated radiation therapy (IMRT). After completion of the therapy, she had regained essentially a full vision with visual acuity OD of 20/30 without corrective lenses. The treatment rationale and pertinent literature are discussed in this article.
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Affiliation(s)
| | - Sanjeev Sharma
- Department of Radiation Oncology, St. Mary's Medical Center
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Adenoid cystic carcinoma presenting as an orbital apex mass with intracranial extension. Can J Ophthalmol 2016; 51:e65-7. [DOI: 10.1016/j.jcjo.2015.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/08/2015] [Accepted: 12/16/2015] [Indexed: 11/17/2022]
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Adenoid cystic carcinoma of the lacrimal gland: CT and MRI findings. Eur J Ophthalmol 2011; 22:316-9. [PMID: 21725943 DOI: 10.5301/ejo.5000015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2011] [Indexed: 12/18/2022]
Abstract
Purpose To highlight the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of lacrimal gland adenoid cystic carcinoma. Methods We reviewed the clinical records and imaging findings of 17 patients who were histopathologically diagnosed with primary adenoid cystic carcinoma of the lacrimal gland between August 1998 and November 2010. Orbital CT scans were performed in 17 patients and MRI scans were obtained in 13 patients. Results On the CT scans, out of 4 cases of adenoid cystic carcinoma, 3 showed characteristic features of a soft tissue mass with poorly enhancing areas representing cystic changes, and 4 of 17 cases had contiguous bony erosion. On the MRI scans, all cases had mixed signal intensity on T2-weighted images, and 6 cases showed poorly enhancing areas. Conclusions Enhanced CT and MRI (including T2-weighted) are helpful in the diagnosis of primary adenoid cystic carcinoma of the lacrimal gland.
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Current world literature. Curr Opin Ophthalmol 2008; 19:435-43. [PMID: 18772678 DOI: 10.1097/icu.0b013e32830d5da2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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