Adenoid Cystic Carcinoma of the Uterine Cervix: A Report of 2 Cases

Rare case of primary adenoid cystic carcinoma of cervix: A case report

INTRODUCTION AND IMPORTANCE

Adenoid cystic carcinoma (ACC) is an uncommon malignant tumor with histological features commonly associated with salivary glands. Although it is thought that human papillomavirus infection is a required cause of most cases of cervical cancer, little is known about its function in the pathophysiology of ACC. Patients with ACC usually present with vaginal bleeding, and physical examination may reveal a firm, palpable mass that may be friable or ulcerated. Cervical ACC is thought to be a radiosensitive tumor, and early-stage patients treated with adjuvant radiation have shown improved outcomes than those seen in cases where surgery has been performed alone. This case is important because there are few case reports in the world, and it is the first case to be reported from Ethiopia.

CASE PRESENTATION

Here we present a 65-year-old female patient presented with vaginal bleeding, and histomorphologic examination confirms the diagnosis of adenoid cystic carcinoma of the cervix.

CLINICAL DISCUSSION

Histologically, these tumors are composed of fairly uniform, small basaloid cells with scanty cytoplasm and rounded or angulated hyperchromatic nuclei. The cells are arranged in a cribriform pattern with central hyaline or mucinous material. Less frequent patterns including trabecular, tubular, solid, or undifferentiated patterns may be observed. Lymph vascular invasion is frequent. This case was confirmed to be primary adenoid cystic carcinoma of the cervix with all features.

CONCLUSION

ACC of the cervix is a rare, particularly aggressive neoplasm. It requires enhancement of postoperative treatment regimens and careful follow-up and thus needs to be distinguished from other tumors with similar histologic aspects. So histopathologic examination with IHC correlation is strongly advised to diagnose this aggressive tumor.

Tumor with slow-developing and recurring lumps of the external ear with skull base and lung metastasis: A case report

The present case report describes a rare case of recurring lumps on the external ear in a 46-year-old Chinese male with a history of >10 years, who presented with large irregular red lumps on the right temple and with lung and skull base metastasis. The patient had a lesion in the right auricle and experienced recurrence following surgical resection. A thorough systemic evaluation revealed no other obvious abnormalities. The patient was diagnosed with adenoid cystic carcinoma (ACC), a slow-growing form of high-grade adenocarcinoma, and refused any further treatment at the present hospital (The First Affiliated Hospital of Army Medical University). At 2 years post-follow-up, the patient had become more frail but was in good spirits. The present study indicated that ACC is a low-grade and commonly slow-developing malignancy that primarily arises from a salivary gland, with recurring and metastatic characteristics.

Coexistence of adenoid cystic carcinoma and squamous cell carcinoma of the uterine cervix with HPV 16 infection: clinical course of delayed adjuvant treatment

Adenoid cystic carcinoma (ACC) is a rare variant of cervical carcinoma and has an aggressive clinical behavior, and there have been few reports of co-existing ACC and squamous cell carcinoma (SCC) of the uterine cervix. A 76-year-old postmenopausal woman presented with vaginal bleeding. The cervical cytology and polypectomy results were SCC, and magnetic resonance imaging (MRI) of pelvis revealed a 2.3 × 1.8 cm sized lobulated mass at the cervix. Microscopically, the tumor showed infiltrative nests of squamoid cells and a cribriform pattern of basaloid cells. Immunohistochemical studies showed that squamous cells were positive for p63 and that basaloid cells were mainly positive for CD117 and S-100 protein. Both components were strongly positive for p16 immunostaining. The tumor was diagnosed as invasive SCC with concurrent ACC. The disease relapsed after a follow-up of 14 months with no adjuvant therapy. Subsequently, she received concurrent chemoradiotherapy (CCRT) and then combined chemotherapy with paclitaxel, cisplatin, and bevacizumab; finally, imaging revealed no evidence of residual cancer.