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Bayani R, Hasanzadeh E, Javadirad E, Azarpeikan AR, Babaei M, Mousavi Darzikolaee N. Complete clinical response to chemoradiation in adenoid cystic carcinoma of the base of tongue: Case report of a rare tumor in a rare location. Clin Case Rep 2024; 12:e9102. [PMID: 38915933 PMCID: PMC11194294 DOI: 10.1002/ccr3.9102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/09/2024] [Accepted: 06/01/2024] [Indexed: 06/26/2024] Open
Abstract
Key Clinical Message Adenoid cystic carcinoma (ACC) is an uncommon malignancy of head and neck. Although the cornerstone of treatment is surgery, concurrent chemoradiotherapy (CRT) might be used as an effective treatment for unresectable tumors. Herein we report a case of massive ACC of base of tongue with durable complete response to definitive CRT. Abstract Adenoid cystic carcinoma (ACC) is a rare tumor accounting for 1% of all head and neck cancers. The best treatment option is complete surgical resection with or without adjuvant radiotherapy. When surgical resection is not feasible, definitive radiotherapy with or without concurrent chemotherapy can be considered. Herein we report a non-smoker 72-year-old woman presented with throat discomfort and sensation of a lump. Evaluation revealed an unresectable adenoid cystic carcinoma of the base of tongue in whom complete clinical response was achieved after definitive concurrent chemoradiation. Although the cornerstone of treatment is complete surgical resection, this case report indicates that concurrent chemoradiotherapy might result in complete clinical response and could be used as a definitive treatment in selected ACC tumors.
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Affiliation(s)
- Reyhaneh Bayani
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, School of MedicineTehran University of Medical SciencesTehranIran
| | - Elyas Hasanzadeh
- Department of Radiation OncologyHamadan University of Medical SciencesHamadanIran
| | - Etrat Javadirad
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Ali Reza Azarpeikan
- Department of Surgical Oncology, Cancer InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad Babaei
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, School of MedicineTehran University of Medical SciencesTehranIran
| | - Nima Mousavi Darzikolaee
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, School of MedicineTehran University of Medical SciencesTehranIran
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Sonone AM, Hande A, Patil SK, Pakhale A, Sharma P, Akolkar S. Unusual Presentation of Adenoid Cystic Carcinoma of the Tongue: A Case Report and Review of the Literature. Cureus 2024; 16:e60825. [PMID: 38910732 PMCID: PMC11190631 DOI: 10.7759/cureus.60825] [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: 04/06/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the salivary glands. Its notable characteristics include aggressive local growth, infiltration of nerves (perineural invasion), a propensity to disseminate to other parts of the body (metastasize), and a high likelihood of recurrence. Here, we present the case of a 71-year-old male patient who presented with swelling on the posterior left side of his tongue, which had been causing him difficulty in chewing for the past six months. The parotid gland is frequently impacted in the head and neck area, with the tongue being comparatively uncommon. While distant metastasis is frequent, metastasis to nearby lymph nodes is not as common. However, if it does occur, it is associated with a poor prognosis and reduces the average survival age of the patient. The preferred treatment for ACC is surgical removal with wide resected margins. If it metastasizes to lymph nodes, then adjunct therapy is the treatment modality for the lesion. ACC exhibits three histopathological patterns: solid, tubular, and cribriform. The solid type is associated with a poorer prognosis compared to cribriform type, which typically has a better prognosis. This case, occurring on the tongue, is rare.
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Affiliation(s)
- Archana M Sonone
- Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Alka Hande
- Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Swati K Patil
- Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Aayushi Pakhale
- Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Preethi Sharma
- Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Sakshi Akolkar
- Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
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Scarpa A, Viola P, Ralli M, Gioacchini FM, Salzano G, Di Stadio A, Cassandro C, Chiarella G, Ricciardiello F, De Luca P, Salzano FA, Avallone E. Post-operative radiotherapy in adenoid cystic carcinoma of salivary glands versus surgery alone: what is the evidence about survival and local control? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:563-571. [PMID: 37796320 DOI: 10.1007/s00405-023-08252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Adenoid cystic carcinoma of the salivary glands is a relatively rare malignancy characterized by slow growth and a poor prognosis, and effective treatments remain challenging to identify. This systematic review, following the PRISMA guidelines, aimed to analyze the potential benefits of post-operative radiotherapy in terms of local control of recurrences and survival advantages when compared with surgery alone in patients with adenoid cystic carcinoma. METHODS A comprehensive systematic review was conducted by searching the MEDLINE, Cochrane, EMBASE, and OVID databases from January 1999 to July 2022. The goal was to identify articles comparing surgery alone with surgery plus postoperative radiotherapy for adenoid cystic carcinoma of the salivary glands. Downs and Black Checklist was used to assess the methodological quality and risk of bias of each included study. The data analysis was performed using Review Manager version 5.4.1. RESULTS This review included 8 studies comprising a total of 3103 patients, divided based on the analyzed outcomes. The pooled odds ratio for overall survival at 5 years was 0.87 (95% confidence interval 0.43-1.76, p = 0.70), and at 10 years was 1.23 (95% confidence interval 0.69-2.16, p = 0.48). In both cases, no statistically significant differences were observed. However, the pooled odds ratio for local control at 5 years was 3.37 (95% confidence interval 1.35-8.42, p = 0.009), providing strong support for the use of post-operative radiation. CONCLUSIONS The findings from the meta-analysis suggest that post-operative radiotherapy significantly improves local control in patients with adenoid cystic carcinoma. However, there was no statistically significant increase in survival at 5 and 10 years. It is essential to note that the quality of the studies included in this meta-analysis ranged from fair to poor. To better clarify the indications for post-operative radiotherapy, future high-quality research is needed, particularly with improved stratification of patient groups. Additionally, it is important to recognize that achieving local control in adenoid cystic carcinoma is crucial for enhancing the overall quality of life for patients. We acknowledge that this review was not registered in the PROSPERO database, and the data pooling was conducted using a random effects model.
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Affiliation(s)
- Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, Salerno, SA, Italy.
| | - Pasquale Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Federico Maria Gioacchini
- ENT Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - Arianna Di Stadio
- Department GF Ingrassia, University of Catania, 95123, Catania, Italy
| | | | - Giuseppe Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | | | - Pietro De Luca
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Via Dell'Amba Aradam, 8, 00184, Rome, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, Salerno, SA, Italy
| | - Emilio Avallone
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover, Germany
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Han N, Li X, Wang Y, Li H, Zhang C, Zhao X, Zhang Z, Ruan M, Zhang C. HIF-1α induced NID1 expression promotes pulmonary metastases via the PI3K-AKT pathway in salivary gland adenoid cystic carcinoma. Oral Oncol 2022; 131:105940. [DOI: 10.1016/j.oraloncology.2022.105940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/14/2022] [Accepted: 05/24/2022] [Indexed: 10/18/2022]
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The efficacy of iodine-125 interstitial brachytherapy for the treatment of locally advanced adenoid cystic carcinoma of the base of tongue: a non-surgical approach. J Contemp Brachytherapy 2021; 13:395-401. [PMID: 34484353 PMCID: PMC8407254 DOI: 10.5114/jcb.2021.108593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/06/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose The present study retrospectively evaluated the effectiveness and safety of iodine-125 interstitial brachytherapy for treatment of primary locally advanced adenoid cystic carcinoma (ACC) of the base of tongue (BOT). Material and methods This study was a retrospective analysis of data of 19 patients with ACC, who were treated with iodine-125 interstitial brachytherapy between March 2008 and April 2018. Overall survival (OS), disease-free survival (DFS), local control (LC), and radiation-related toxicities were determined. Factors affecting the outcomes were evaluated. Results Six males and 13 females were included in our study, with a median follow-up time of 35 months. 3- and 5-year OS rates were 71.5% and 47.6%, respectively. 3- and 5-year LC rates were 88.5% and 34.5%, respectively. 3- and 5-year DFS rates were 54.7% and 21.9%, respectively. A significant difference was observed in patients with or without brain metastases for OS rate. No severe acute toxicity was observed, while severe late toxicity was observed in one patient. Conclusions The results suggest that iodine-125 interstitial brachytherapy is an effective and safe option for the treatment of primary locally advanced ACC of the base of the tongue, with reasonably satisfactory LC and OS.
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Takayama K, Kato T, Nakamura T, Azami Y, Ono T, Suzuki M, Takada A, Yamaguchi H, Seto I, Nakasato T, Wada H, Kikuchi Y, Mitsudo K, Fuwa N, Murakami M. Proton beam therapy combined with intra-arterial infusion chemotherapy for stage Ⅳ adenoid cystic carcinoma of the base of the tongue. TOUKEIBU GAN 2021; 47:21-29. [DOI: 10.5981/jjhnc.47.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Affiliation(s)
- Kanako Takayama
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
| | - Takahiro Kato
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Yusuke Azami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Takashi Ono
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | | | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Ichiro Seto
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | | | - Hitoshi Wada
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital
| | - Masao Murakami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center
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Nava-Castañeda Á, Kahuam-López N, De La Fuente Díez Y, Velásco Y Levy A, Sánchez-Bonilla FG, Martín F, Garnica-Hayashi L, Rodriguez-Reyes A. Primary adenoid cystic carcinoma arising from an ectopic lacrimal gland involving both nasal orbits: a rare clinical entity. Orbit 2020; 40:525-528. [PMID: 32912017 DOI: 10.1080/01676830.2020.1817948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Adenoid cystic carcinoma (ACC) is a slow-growing, locally invasive tumor of epithelial origin. The common sites of origin are the minor and major salivary glands and also the lacrimal glands. ACC accounts for 4.8% of primary orbital neoplasms and commonly arises superolaterally from the main lacrimal gland. Primary ACC of the orbit from an extra lacrimal region is quite rare. We present a case of ACC that occurred in ectopic lacrimal gland tissue involving the medial region of both orbits. A 74-year-old woman was admitted with a 4-week history of progressive painful proptosis in her left eye. Examination revealed a medium-size bilateral nasal canthal mass. Computed tomography (CT) scan revealed a nasal mass in both orbits with bone erosion. The patient underwent bilateral anterior orbitotomy and incisional biopsy was performed. Histopathology exam revealed an ACC with perineural and bone invasion. She refused orbital exenteration and radiation therapy was initiated.
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Affiliation(s)
- Ángel Nava-Castañeda
- Oculoplastics Department, Insituto De Oftalmología Fundación Conde De Valenciana, Mexico City, Mexico
| | - Nicolás Kahuam-López
- Oculoplastics Department, Insituto De Oftalmología Fundación Conde De Valenciana, Mexico City, Mexico
| | - Yesica De La Fuente Díez
- Oculoplastics Department, Insituto De Oftalmología Fundación Conde De Valenciana, Mexico City, Mexico
| | - Adriana Velásco Y Levy
- Oculoplastics Department, Insituto De Oftalmología Fundación Conde De Valenciana, Mexico City, Mexico
| | | | - Fernando Martín
- Oculoplastics Department, Insituto De Oftalmología Fundación Conde De Valenciana, Mexico City, Mexico
| | - Lilia Garnica-Hayashi
- Oculoplastics Department, Insituto De Oftalmología Fundación Conde De Valenciana, Mexico City, Mexico
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Takayama K, Kato T, Nakamura T, Azami Y, Ono T, Suzuki M, Takada A, Yamaguchi H, Seto I, Nakasato T, Wada H, Kikuchi Y, Mitsudo K, Fuwa N, Murakami M. Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue. Cancers (Basel) 2019; 11:cancers11101413. [PMID: 31546728 PMCID: PMC6826952 DOI: 10.3390/cancers11101413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/12/2019] [Accepted: 09/20/2019] [Indexed: 01/06/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a very rare epithelial tumor of the salivary glands. Surgical resection is considered to be a standard therapy. However, the optimal treatment strategy for managing advanced cases has not yet been established. This study evaluated the efficacy and toxicity of proton beam therapy (PBT) combined with selective intra-arterial infusion chemotherapy (IAIC) using weekly cisplatin for locally advanced ACC of the base of the tongue. Between March 2009 and February 2018, 15 patients were treated. The median follow-up duration was 56 (range: 15–116) months. The 5-year local control and overall survival rates were 89% and 76%, respectively. With regard to late toxicities, grade 2 osteoradionecrosis was found in one patient and grade 5 pharyngeal necrosis was observed in one patient. Considering most cases were significantly advanced and inoperable, this therapy was effective in controlling the primary tumor, preserving function and maintaining the quality of life. Although improvements are needed to reduce adverse events, PBT in combination with IAIC can be a treatment option for locally advanced ACC of the base of the tongue.
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Affiliation(s)
- Kanako Takayama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Takahiro Kato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Yusuke Azami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Takashi Ono
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Akinori Takada
- Department of Radiation Oncology, Mie University Hospital, 2-174, Edobashi Tsu, Mie 514-8507, Japan.
| | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Ichiro Seto
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Tatsuhiko Nakasato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Hitoshi Wada
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise red cross hospital, 1-471-2, Funae, Ise, Mie 516-8512, Japan.
| | - Masao Murakami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
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Tang X, Zhang C, Chen R, Zhou X, Zhang Y. Treatment of adenoid cystic carcinoma of the mobile tongue with anterolateral thigh flap reconstruction: A case report. Medicine (Baltimore) 2019; 98:e15250. [PMID: 31008961 PMCID: PMC6494219 DOI: 10.1097/md.0000000000015250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm of the salivary glands. The clinical and pathological characteristics include slow growth, perineural invasion, and local recurrence. ACC of the mobile tongue is rarely reported in the literature. PATIENT CONCERNS We describe a case of a 43-year-old man patient with numbness and growth in the tongue for 1 month duration. The patient reported a long-term smoking and drinking habit. DIAGNOSES A biopsy was carried out and histopathological analysis confirmed as diagnosis of adenoid cystic carcinoma. Computed tomography (CT) of the head and neck enhanced scanning revealed an ill-defined high density mass with altered enhanced signal entities involving the anterior 2/3rd of the tongue. INTERVENTIONS The patient was treated with surgery and adjuvant radiotherapy. Incision was placed over the anteriorly till 2/3rd of tongue and then the femoral anterolateral free flap was used to repair and reconstruct the defect of tongue. OUTCOME The patient is currently under a postsurgical 29-month regular follow-up, showing good swallowing and speaking function without any recurrence and metastasis. LESSONS This case report suggests that surgery and adjuvant radiotherapy are suitable procedures for patients with resectable ACC of the mobile tongue.
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Affiliation(s)
- Xi Tang
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
| | - Chengyao Zhang
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
| | - Rui Chen
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
- Department of Pathology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, P.R. China
| | - Xiaohong Zhou
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
| | - Yulian Zhang
- Department of Head and Neck Cancer Center
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment
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Luna-Ortiz K, Hidalgo-Bahena SC, Muñoz-Gutiérrez TL, Mosqueda-Taylor A. Tumors of the oral cavity: CO2 laser management. Med Oral Patol Oral Cir Bucal 2019; 24:e84-e88. [PMID: 30573713 PMCID: PMC6344001 DOI: 10.4317/medoral.22811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cancer of the oral cavity combined with oropharyngeal cancer is the sixth leading cause of death for cancer worldwide. Surgery remains the standard treatment for this disease in early clinical and locally advanced stages. Numerous studies have shown that laser management is useful for premalignant lesions in the oral cavity; however, there is no conclusive evidence that its use is appropriate in cancer of the oral cavity and that results are comparable with traditional surgery. The objective of this study is to determine cancer control after wide local resection with CO2 laser for oral malignant neoplasms. MATERIAL AND METHODS Retrospective study in patients with tumors of the oral cavity who were considered for surgical resection with CO2 laser from January 2006-December 2015. Demographic data, treatment modalities, histopathological diagnosis and clinical stage variables were obtained. All resections were done with the use of the microspot. Patients with cancer of the tongue were not included because a specific protocol for these patients does exist in our institution. RESULTS There were twenty patients, 10 male and 10 female with a average age of 58 years (range: 20-92 years). Mean age was 53.5 years for females and 63 years for males. Twelve (60%) patients are alive and disease free and four (20%) were lost free of disease. CONCLUSIONS CO2 laser is an acceptable surgical method for the management of small lesions in the oral cavity. We cannot rule out that small lesions of the oral cavity with positive neck could be managed in this manner, adding treatment to the neck, producing an adequate local regional control. However, this hypothesis requires additional studies.
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Affiliation(s)
- K Luna-Ortiz
- Department of Head and Neck Surgery, Instituto Nacional de Cancerologia (Mexico), Av. San Fernando #22, Col. Sección XVI, Tlalpan Mexico,
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Kirke DN, Chitguppi C, Rubin SJ, Truong MT, Jalisi S. Adenoid cystic carcinoma of the base of tongue: A population-based study. Am J Otolaryngol 2017; 38:279-284. [PMID: 28173954 DOI: 10.1016/j.amjoto.2017.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The objective was to assess demographic and survival patterns in patients with adenoid cystic carcinoma of the base of tongue. METHODS Patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1973 through 2012 and were categorized by age, gender, race, historical stage A, and treatment. Incidence and survival were compared with Kaplan Meier curves and mortality hazard ratios. RESULTS A total of 216 patients were included. After adjusting for age, gender, race and tumor-directed treatment, patients over the age of 70years had a significantly increased mortality [HR=2.847, 95% CI (1.499, 5.404) p=0.0014]. Furthermore mortality among patients with distant disease was significantly increased [HR=2.474 95% CI (1.459, 4.195) p=0.00008]. CONCLUSION By examining the largest collection of patients we have demonstrated that there is a significant difference in mortality based on both the age at diagnosis and in the setting of distant disease.
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12
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Han N, Ong H, Liu Z, Ruan M, Yang W, Zhang C. Lymph node involvement predicts poor prognosis in primary tongue adenoid cystic carcinoma: A preliminary study of 54 cases. J Craniomaxillofac Surg 2017; 45:589-594. [DOI: 10.1016/j.jcms.2017.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/13/2016] [Accepted: 01/17/2017] [Indexed: 01/20/2023] Open
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Wee HE, Azhar R, Tang PY, Teo TH, Iyer NG, Tan HK, Tan NC. Diagnostic pitfall: Adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy, case report and literature review. Int J Surg Case Rep 2016; 25:102-5. [PMID: 27343735 PMCID: PMC4925904 DOI: 10.1016/j.ijscr.2016.05.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/16/2022] Open
Abstract
Adenoid Cystic Carcinoma is a malignant neoplasm originating in both major and minor salivary glands. It is characterized by slow progression, local invasiveness and perineural invasion. It may present as a hypoglossal nerve palsy. When the diagnosis is in doubt, we suggest examination under anasthesia and deep biopsy.
Introduction We describe a patient with an unusual presentation of an isolated hypoglossal nerve palsy as a result of perineural invasion (PI) from adenoid cystic carcinoma (ACC). We will also discuss the diagnostic pitfalls as well as present a short literature review of adenoid cystic carcinomas and suggest improvement to the current diagnostic algorithm for isolated hypoglossal nerve palsies. Presentation of case A 63 year old Malay female presented with progressive dysphagia and slurred speech for one year. Physical examination showed unilateral right tongue wasting, fasciculation and deviation to the right. An MRI showed atrophy of the tongue due to denervation and subsequently she was treated in a neurology clinic for 8 months. Due to lack of improvement, she was referred to our surgical unit and underwent examination under anaesthesia (EUA) and biopsy. Histology showed adenoid cystic carcinoma with perineural involvement, resulting in lower motor neuron signs. She underwent radiotherapy to the base of her tongue (70 Gy/35#). A PET-CT one month post treatment showed complete response. Discussion Adenoid cystic carcinoma (ACC) is a salivary gland neoplasm. It is characterized by local invasiveness with frequent recurrence and indolent growth. It affects major salivary glands more than minor salivary glands. In malignancies that have a propensity for PI such as ACC, patients may present atypically with nerve palsies. In infiltrative lesions, the primary tumour may not be evident on magnetic resonance imaging. Therefore, to achieve a diagnosis, a high index of suspicion is required. When the diagnosis is in question, deep biopsy and positron emission tomography may be useful.
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Affiliation(s)
- Hide Elfrida Wee
- Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
| | - Rafay Azhar
- Singapore General Hospital, Outram Rd, Singapore 169608.
| | - Po Yin Tang
- Singapore General Hospital, Outram Rd, Singapore 169608.
| | - Tze Hern Teo
- Division of Oncologic Imaging, National Cancer Center Singapore, 11 Hospital Drive, Singapore 169610.
| | | | - Hiang Khoon Tan
- Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
| | - Ngian Chye Tan
- Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610.
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Kumar S, Agarwal P, Nimmi V. Adenoid cystic carcinoma: A rare late presentation of the mobile tongue. J Oral Biol Craniofac Res 2016; 6:164-7. [PMID: 27195216 DOI: 10.1016/j.jobcr.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/21/2016] [Indexed: 11/19/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm of the salivary glands. We present a case of a 70-year-old male patient with a swelling over the dorsal and ventral surface of anterior two third of the tongue which was causing him difficulty in mastication since 10 months. Ultrasound and magnetic resonance imaging were done following which the surgical excision of the lesion was performed and histopathological diagnosis of ACC was achieved. It was rare to find ACC in such an old man with such a large lesion presenting so late in the rare site of the mobile tongue. ACC is a slowly growing, highly invasive cancer with a high recurrence rate and chances of metastases, so surgery is the choice of treatment with mandatory long-term follow-up.
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Affiliation(s)
- Sanjay Kumar
- Senior Resident, Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Padmanidhi Agarwal
- Senior Resident, Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - V Nimmi
- Junior Resident, Department of Conservative Dentistry & Endodontics, Government Dental College, Kottayam, Kerala, India
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Koto M, Hasegawa A, Takagi R, Ikawa H, Naganawa K, Mizoe JE, Jingu K, Tsujii H, Tsuji H, Kamada T, Okamoto Y. Evaluation of the safety and efficacy of carbon ion radiotherapy for locally advanced adenoid cystic carcinoma of the tongue base. Head Neck 2016; 38 Suppl 1:E2122-6. [PMID: 26854882 DOI: 10.1002/hed.24397] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Most cases of adenoid cystic carcinoma (ACC) of the tongue base are radioresistant, and are diagnosed in the advanced stage. Therefore, we evaluated the safety and efficacy of carbon ion radiotherapy (C-ion RT) for locally advanced ACC of the tongue base. METHODS Eighteen patients with ACC of the tongue base were treated with C-ion RT between May 2002 and April 2014. Seventeen patients had T4a disease and 1 patient had T2 disease before C-ion RT. RESULTS The median follow-up period was 57 months (range, 10-132 months). The 5-year local control rate was 92%. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 72% and 44%, respectively. Regarding late reactions, 2 patients developed grade 3 mandible osteoradionecrosis, and 1 had grade 3 hemorrhage of the tongue base. CONCLUSION C-ion RT was effective with acceptable toxicities for locally advanced ACC of the tongue base. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2122-E2126, 2016.
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Affiliation(s)
- Masashi Koto
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Azusa Hasegawa
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Ryo Takagi
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Hiroaki Ikawa
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Kensuke Naganawa
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | | | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan
| | - Hirohiko Tsujii
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Hiroshi Tsuji
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Tadashi Kamada
- Research Center for Charged Particle Therapy Hospital, National Institute of Radiological Sciences, Chiba, Japan
| | - Yoshitaka Okamoto
- Department of Otolaryngology, Chiba University School of Medicine, Chiba, Japan
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Singh FM, Mak SY, Bonington SC. Patterns of spread of head and neck adenoid cystic carcinoma. Clin Radiol 2015; 70:644-53. [PMID: 25770022 DOI: 10.1016/j.crad.2015.01.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/14/2015] [Accepted: 01/23/2015] [Indexed: 02/04/2023]
Abstract
We present a review of head and neck adenoid cystic carcinoma (ACC). Imaging features of the primary tumour, patterns of locoregional spread, and distant metastasis with emphasis on perineural extension and imaging pitfalls are discussed with illustrated examples.
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Affiliation(s)
- F M Singh
- The Christie NHS Foundation Trust, Manchester, UK; North Western Deanery School of Radiology, Manchester, UK.
| | - S Y Mak
- The Christie NHS Foundation Trust, Manchester, UK
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Sa YJ, Sim SB, Kim TJ, Moon SW, Park CB. Late-developing tongue adenoid cystic carcinoma after pulmonary metastasectomy: a case report. World J Surg Oncol 2014; 12:102. [PMID: 24750665 PMCID: PMC3996496 DOI: 10.1186/1477-7819-12-102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 04/07/2014] [Indexed: 11/10/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is a relatively rare epithelial tumor of the salivary glands that accounts for approximately 5 to 10% of all salivary gland neoplasms. The typical clinical and pathological findings of this tumor include slow indolent growth, common local recurrence, and late distant metastasis to lung, brain, bone, liver, thyroid, and spleen. We report a 52-year-old female patient who presented a tongue ACC, 27 months after successful pulmonary ACC resection.
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Affiliation(s)
| | | | | | | | - Chan Beom Park
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
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Mesolella M, Luce A, Marino A, Caraglia M, Ricciardiello F, Iengo M. Treatment of c-kit positive adenoid cystic carcinoma of the tongue: A case report. Oncol Lett 2014; 8:309-312. [PMID: 24959267 PMCID: PMC4063594 DOI: 10.3892/ol.2014.2075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 03/20/2014] [Indexed: 01/09/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) or ‘cylindroma’ is a malignant tumor that often occurs in the areas of the head and neck, affecting the secretory glands and the major and minor salivary glands. The present study describes a case of a patient who presented with a posterior tongue lesion. The case is of a 71-year-old female with an asymptomatic volume growth of the posterior left tongue perceived 8 months prior, and neoplastic cells positive for c-kit. A computed tomography of the head and neck showed asymmetry of the base of the tongue, which was enlarged in the left portion. A physical examination revealed a nodule on the posterior left tongue of ~3 cm in diameter, while the cervical lymph node chain had a normal size and consistency. Surgical exeresis of the tongue lesion and cervical lymph node dissection were performed. Subsequent to surgical removal of the cancer cells and adjuvant radiotherapy, the patient showed excellent health, although the follow-up remains in progress. ACC, one of the most biologically destructive tumors of the head and neck, is locally aggressive and gives rise to distant metastases. The tongue is the place of origin in 3.4–17.1% of cases. The treatment for ACC consists of primary surgical resection with adjuvant radiotherapy. To prevent the risk for distant metastasis, it is necessary to remove the first echelon nodes and monitor the patient with a long-term follow-up.
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Affiliation(s)
- Massimo Mesolella
- Ear, Nose and Throat Department, University 'Federico II', Naples I-80138, Italy
| | - Amalia Luce
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples I-80138, Italy
| | - Anna Marino
- Ear, Nose and Throat Department, University 'Federico II', Naples I-80138, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples I-80138, Italy
| | | | - Maurizio Iengo
- Ear, Nose and Throat Department, University 'Federico II', Naples I-80138, Italy
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Terada T. Adenoid cystic carcinoma of the oral cavity: immunohistochemical study of four cases. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2013; 6:932-938. [PMID: 23638226 PMCID: PMC3638105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 03/27/2013] [Indexed: 06/02/2023]
Abstract
Adenoid cystic carcinoma (ACC) in the oral cavity is rare, and no immunohistochemical studies of ACC in the oral cavity have been performed. This report describes the immunohistochemical study of four ACCs of the oral cavity. The male to female ratio was 1:3. The age was 43, 51, 59 and 64 years. The location was tongue (n=2), buccal mucosa (n=1), and gingiva (n=1). Histochemically, all ACCs were positive for neutral, carboxylated and sulfated mucins. Immunohistochemically, ACC was consistently positive for cytokeratin (CK) AE1/3, CK 34βE12, CK5/6, CK7, CK14, CK18, p63, CA19-9, c-KIT (CD117), PDGFRA, MUC1, and Ki-67 (labeling index: 5%, 15%, 20% and 40%). ACC was consistently negative for CK8, CK20, desmin, S100 protein, CD34, chromogranin, MUC2, MUC5AC and MUC6. Some ACCs were positive for CK CAM5.2 (3/4), CK19 (1/4), EMA (2/4), CEA (2/4), vimentin (3/4), α-smooth muscle actin (2/4), p53 (2/4), CD10 (2/4), and synaptophysin (1/4). These results may provide basic knowledge of ACC of the oral cavity.
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Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.
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Ajila V, Hegde S, Nair GR, Babu SG. Adenoid cystic carcinoma of the buccal mucosa: A case report and review of the literature. Dent Res J (Isfahan) 2013; 9:642-6. [PMID: 23559934 PMCID: PMC3612206 DOI: 10.4103/1735-3327.104888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Adenoid cystic carcinomas are deceptive malignancies that show slow growth and local invasion with recurrences seen many years after diagnosis. Upto 50% of these tumors occur in the intraoral minor salivary glands usually in the hard palate. Buccal mucosal tumors are relatively rare. We determined the incidence of buccal mucosal adenoid cystic carcinoma by reviewing the number of reported cases in the literature. This is the first article to analyze the occurrence of adenoid cystic carcinomas in the buccal mucosa through a review of 41 articles. Our review revealed 178 buccal mucosal adenoid cystic carcinomas among a total of 2,280 reported cases. We present a case of adenoid cystic carcinoma occurring in the left buccal mucosa of a 45-year-old female.
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Affiliation(s)
- Vidya Ajila
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Deralakatte, Mangalore, India
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Adenoid cystic carcinoma of the external auditory canal associated with cholesteatoma in an 8-year-old girl. Int J Pediatr Otorhinolaryngol 2013; 77:150-2. [PMID: 23073170 DOI: 10.1016/j.ijporl.2012.09.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 09/21/2012] [Accepted: 09/24/2012] [Indexed: 02/04/2023]
Abstract
Adenoid cystic carcinoma of the external auditory canal is very rare in a child, and has not previously been reported in an individual younger than 18 years. We report an 8-year-old girl with adenoid cystic carcinoma of the external auditory canal associated with cholesteatoma. At the time of diagnosis, the tumor had invaded the surrounding structures and metastasized to the lymph nodes. She underwent palliative surgery and radiotherapy. She subsequently deteriorated and died of her disease 31 months later.
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Adenoid cystic carcinoma of the mobile tongue: A rare case. Dent Res J (Isfahan) 2012; 9:S115-8. [PMID: 23814551 PMCID: PMC3692189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) occurs more commonly in the minor salivary glands of the palate on than the tongue. ACC is a malignant neoplasm that accounts for 1-2% of all head and neck malignancies and 10-15% of all salivary gland malignancies. ACC affects the exocrine glands at any site, but the parotid gland is the most common site in the head and neck region. Many factors should be taken into account in the prognosis of ACC, including the histological and clinical stages of the disease. The most striking feature of ACC is that it is locally aggressive, with a high recurrence level, perineural invasion and distant metastases, especially to the lungs and bones. The most common presentation histologically is the presence of cribriform appearance (Swiss cheese pattern). The present case is a rare one present on the tongue.
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Zhou Q, Chang H, Zhang H, Han Y, Liu H. Increased numbers of P63-positive/CD117-positive cells in advanced adenoid cystic carcinoma give a poorer prognosis. Diagn Pathol 2012; 7:119. [PMID: 22963430 PMCID: PMC3487809 DOI: 10.1186/1746-1596-7-119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 08/31/2012] [Indexed: 11/12/2022] Open
Abstract
Objectives This study consisted of two parts. One part was to analyze the survival rates of adenoid cystic carcinoma (ACC) in Chinese and explain the difference between our data and the literature. The other was to analyze the relationship between the expression of CD117 and the histological grade and the prognosis. Methods A retrospective study of 80 ACC patients was performed. Clinical data were collected, and p63, CD117 were detected by immunohistochemical staining. Results Eighty patients received follow-ups 3 to 216 months after initial diagnosis. ACC occurred in the lacrimal gland (26.3%, n = 21), nasal cavity and parasinus (33.8%, n = 27) and other sites (40.0%, n = 33). The 5-year and 10-year survival rates were 66.41% and 10.16%, respectively. Over expression of CD117 was detected in p63-negative cells in 94.3% of cases and in p63-positive cells in 45.8%. The expression of CD117 in p63-positive cells was significantly associated with the histological grade (P<0.001) and prognosis (P = 0.037) in patients in the advanced stage. Conclusions ACC had a good 5-year survival but poor 10-year survival in Chinese, which differed from the occidental data. More p63+/CD117+ cells were associated with a higher histological grade and poorer outcome. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1701457278762097
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Affiliation(s)
- Quan Zhou
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Dongjiaominxiang No, 1 Dongcheng District, Beijing, China
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Graça SAR, Sequeira H, Coelho G, Costa H. Adenoid cystic carcinoma of head and neck: apropos of a case. BMJ Case Rep 2012; 2012:bcr0220125914. [PMID: 22914229 PMCID: PMC4543138 DOI: 10.1136/bcr-02-2012-5914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant neoplasm, arising from glandular tissues, found mainly in the head and neck. Generally, it presents insidiously but can behave aggressively making its course unpredictable. Surgery and adjuvant radiotherapy continue to be the cornerstone for its treatment. ACC remains extremely difficult to treat. The authors report a case of a 37-year-old woman with bloody rhinorrhea for 6 months. She was diagnosed with a left nasal cavity lesion that was biopsied, and the anatomopathological result showed ACC. The patient was submitted to a left extended maxillectomy, microsurgical reconstruction and radiotherapy.
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Affiliation(s)
| | - Hugo Sequeira
- Department of Plastic, Reconstructive and Maxillofacial Surgery, CHVNG/E, EPE, Gaia, Portugal
| | - Gustavo Coelho
- Department of Plastic, Reconstructive and Maxillofacial Surgery, CHVNG/E, EPE, Gaia, Portugal
| | - Horácio Costa
- Department of Plastic, Reconstructive and Maxillofacial Surgery, CHVNG/E, EPE, Gaia, Portugal
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Akhavan A, Navabii H, Saeb M. Adenoid cystic carcinoma of base of tongue. BMJ Case Rep 2012; 2012:bcr.02.2012.5853. [PMID: 22744242 DOI: 10.1136/bcr.02.2012.5853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant tumour arising from salivary glands. ACC of the head and neck shows a long natural course, high recurrence rates, late metastasis and a tendency for perineural invasion. The authors present a woman with ACC at base of tongue with good response to radiotherapy.
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Affiliation(s)
- Ali Akhavan
- Radiotherapy Department, Shahid Sadoghi University, and Medical Physics Department, Isfahan Milad Hospital, Yazd, Iran.
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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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Unusual presentations of adenoid cystic carcinoma in extra-salivary gland subsites in head and neck region: a case series. Indian J Otolaryngol Head Neck Surg 2012; 66:286-90. [PMID: 24533400 DOI: 10.1007/s12070-012-0490-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 01/19/2012] [Indexed: 10/28/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is an uncommon malignant epithelial tumor occurring in head neck region, accounting for approximately 10% of all salivary gland neoplasms. Extra-salivary gland involvement of other head neck subsites by ACC may present in unusual modes creating clinical dilemma. Here we present some cases with extra-salivary gland ACC. In this series six cases with extra-salivary gland ACC were included. Three patients presented with external auditory canal and temporo-mastoid region involvement of whom two cases also had intracranial extension. In one case tongue was the site of involvement where it was confused with benign neurogenic tumour. Palatal erosion with formation of oro-nasal fistula was the the manifestation of ACC involving palate. On the other hand sinonasal bleeding mass which came out as ACC on histopathological examination did not cause any palatal erosion and was removed successfully via lateral rhiniotomy. In all these cases patients were treated with post-operative radiotherapy and were closely followed up for early detection of any distant metastasis. The experience about the various unusual manifestations of ACC and the therapeutic challenge poised by the cases is discussed here.
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Adenoid cystic carcinoma of buccal mucosa. J Maxillofac Oral Surg 2010; 9:273-6. [PMID: 22190804 DOI: 10.1007/s12663-010-0086-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 04/24/2010] [Indexed: 10/18/2022] Open
Abstract
Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in salivary glands of head and neck region. Here we present a case report of a 50 year old male who was diagnosed with adenoid cystic carcinoma of the right buccal mucosa. The peculiarity of the lesion and the approach we made is the key factor in the presentation.
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