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Costa RF, de Oliveira CA, Gomes ÁNDM, Lourenço SV, Coutinho-Camillo CM. Molecular Aspects of Mucoepidermoid Carcinoma and Adenoid Cystic Carcinoma of the Salivary Gland. Head Neck Pathol 2024; 18:34. [PMID: 38658430 PMCID: PMC11043314 DOI: 10.1007/s12105-024-01629-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Salivary gland tumors (SGTs) are rare and highly heterogeneous lesions, making diagnosis a challenging activity. In addition, the small number of studies and samples evaluated difficults the determination of prognosis and diagnosis. Despite the solid advances achieved by research, there is still an intense need to investigate biomarkers for diagnosis, prognosis and that explain the evolution and progression of SGTs. METHODS We performed a comprehensive literature review of the molecular alterations focusing on the most frequent malignant SGTs: mucoepidermoid carcinoma and adenoid cystic carcinoma. RESULTS Due to the importance of biomarkers in the tumorigenenic process, this review aimed to address the mechanisms involved and to describe molecular and biomarker pathways to better understand some aspects of the pathophysiology of salivary gland tumorigenesis. CONCLUSIONS Molecular analysis is essential not only to improve the diagnosis and prognosis of the tumors but also to identify novel driver pathways in the precision medicine scenario.
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Affiliation(s)
- Raisa Ferreira Costa
- International Research Center, A.C.Camargo Cancer Center, Rua Taguá, 440 - Primeiro andar, São Paulo, 01508-010, Brazil
| | - Carolinne Alves de Oliveira
- International Research Center, A.C.Camargo Cancer Center, Rua Taguá, 440 - Primeiro andar, São Paulo, 01508-010, Brazil
| | - Ágatha Nagli de Mello Gomes
- International Research Center, A.C.Camargo Cancer Center, Rua Taguá, 440 - Primeiro andar, São Paulo, 01508-010, Brazil
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Horio Y, Kuroda H, Masago K, Matsushita H, Sasaki E, Fujiwara Y. Current diagnosis and treatment of salivary gland-type tumors of the lung. Jpn J Clin Oncol 2024; 54:229-247. [PMID: 38018262 DOI: 10.1093/jjco/hyad160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/02/2023] [Indexed: 11/30/2023] Open
Abstract
Salivary gland-type tumors of the lung are thought to originate from the submucosal exocrine glands of the large airways. Due to their rare occurrence, reports of their study are limited to small-scale or case reports. Therefore, daily clinical practices often require a search for previous reports. In the last 20 years, several genetic rearrangements have been identified, such as MYB::NF1B rearrangements in adenoid cystic carcinoma, CRTC1::MAML2 rearrangements in mucoepidermoid carcinoma, EWSR1::ATF1 rearrangements in hyalinizing clear cell carcinoma and rearrangements of the EWSR1 locus or FUS (TLS) locus in myoepithelioma and myoepithelial carcinoma. These molecular alterations have been useful in diagnosing these tumors, although they have not yet been linked to molecularly targeted therapies. The morphologic, immunophenotypic, and molecular characteristics of these tumors are similar to those of their counterparts of extrapulmonary origin, so clinical and radiologic differential diagnosis is required to distinguish between primary and metastatic disease of other primary sites. However, these molecular alterations can be useful in differentiating them from other primary lung cancer histologic types. The management of these tumors requires broad knowledge of the latest diagnostics, surgery, radiotherapy, bronchoscopic interventions, chemotherapy, immunotherapy as well as therapeutic agents in development, including molecularly targeted agents. This review provides a comprehensive overview of the current diagnosis and treatment of pulmonary salivary gland tumors, with a focus on adenoid cystic carcinoma and mucoepidermoid carcinoma, which are the two most common subtypes.
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Affiliation(s)
- Yoshitsugu Horio
- Department of Outpatient Services, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Thoracic Surgery, Teikyo University Hospital, Mizonokuchi, Kanagawa-prefecture, Japan
| | - Katsuhiro Masago
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hirokazu Matsushita
- Division of Translational Oncoimmunology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Eiichi Sasaki
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yutaka Fujiwara
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Peng L, Li J, Li W, Jia Y, Zhao J, Zhang J. [Diagnosis and treatment of subglottic mass(report of 5 cases)]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 38:246-250. [PMID: 38433696 DOI: 10.13201/j.issn.2096-7993.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Indexed: 03/05/2024]
Abstract
Subglottic masses is very rare. The clinical data of five cases of subglottic mass in our hospital from 2017 to 2022 were summarized, and their clinical manifestations, auxiliary examination findings, treatment plan and pathological features were analyzed. Among the 5 patients, 1 case was subglottic pleomorphic adenoma, 1 case was subglottic granuloma, 1 case was subglottic breast cancer metastasis, 1 case was subglottic primary adenoid cystic carcinoma, and 1 case was immunoglobulin G4-related disease. No recurrence was observed in the patients so far. Subglottic mass is easy to be missed. Therefore, when the lesion is suspected in this area, the examination of ear, nose and throat should be carried out systematically to detect the lesion early and improve the prognosis.
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Affiliation(s)
- Lili Peng
- Department of Laryngopharyngeal Surgery,Sixth Medical Center of PLA General Hospital,Beijing,100048,China
| | - Jinrang Li
- Department of Laryngopharyngeal Surgery,Sixth Medical Center of PLA General Hospital,Beijing,100048,China
| | - Weimin Li
- Department of Laryngopharyngeal Surgery,Sixth Medical Center of PLA General Hospital,Beijing,100048,China
| | - Yuanyuan Jia
- Department of Laryngopharyngeal Surgery,Sixth Medical Center of PLA General Hospital,Beijing,100048,China
| | - Jing Zhao
- Department of Laryngopharyngeal Surgery,Sixth Medical Center of PLA General Hospital,Beijing,100048,China
| | - Jianqiao Zhang
- Department of Otolaryngology,Angji District Hospital of Langfang City
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Zhu YL, Li Y, Mu JL, Liu WC, Li X, Lu HZ. [Correlation of MYB/NFIB gene fusion with the grade and prognosis of head and neck adenoid cystic carcinoma and the concordance of two detection methods]. Zhonghua Bing Li Xue Za Zhi 2024; 53:149-154. [PMID: 38281782 DOI: 10.3760/cma.j.cn112151-20230914-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Objective: To explore the correlation between MYB/NFIB gene fusion and clinicopathological features such as tumor grade and prognosis of head and neck adenoid cystic carcinoma (ACC), and to assess the concordant rate of fluorescent in situ hybridization (FISH) with MYB and NFIB immunohistochemistry. Methods: FISH detection of MYB/NFIB gene fusion was performed on 48 head and neck ACC cases and 15 non-ACC salivary gland tumors at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China during April 2014 and January 2020. ACC cases were divided into grade Ⅰ-Ⅱ, grade Ⅲ and high-grade transformation, according to pathological grading criteria. Prognosis, FISH results and other clinicopathological characteristics were analyzed. MYB and NFIB immunohistochemistry was performed on the 48 ACC and 15 non-ACC cases. The diagnostic accuracy of FISH and immunohistochemistry was compared. Results: FISH detected MYB/NFIB gene fusion in 41.7% (20/48) of the ACC. Its positive rate was inversely correlated with higher pathological grades (P=0.036). The higher histological grade was linked to worse progression-free survival (P=0.024), whereas there was no correlation between the status of gene fusion detected by FISH and progression-free survival (P=0.536). FISH didnot detect MYB/NFIB gene fusion in 15 non-ACC salivary gland tumors The specificity of diagnosing ACC is 100% for both FISH detection of gene fusion and immunohistochemical detection of MYB expression. However, the sensitivity for both methods was only about 41.7%, respectively. By combining FISH and MYB immunohistochemistry, the sensitivity for diagnosing ACC was increased to 66.7%. Conclusions: MYB/NFIB gene fusion has a lower detection rate in grade Ⅲ ACC and high-grade transformation ACC. Meanwhile gene fusion status is not correlated with prognosis. The sensitivity for diagnosing ACC can be improved by combining FISH and MYB immunohistochemistry.
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Affiliation(s)
- Y L Zhu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
| | - Y Li
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
| | - J L Mu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
| | - W C Liu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
| | - X Li
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
| | - H Z Lu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
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Takamori S, Yatabe Y, Osoegawa A, Aokage K, Yoshioka H, Miyoshi T, Mimae T, Endo M, Hattori A, Yotsukura M, Isaka T, Isaka M, Maniwa T, Nakajima R, Watanabe SI. Rare but clinically important salivary gland-type tumor of the lung: A review. Jpn J Clin Oncol 2024; 54:121-128. [PMID: 37952098 DOI: 10.1093/jjco/hyad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Salivary gland-type tumor (SGT) of the lung, which arises from the bronchial glands of the tracheobronchial tree, was first recognized in the 1950s. SGT represents less than 1% of all lung tumors and is generally reported to have a good prognosis. Mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) are the two most common subtypes, comprising more than 90% of all SGTs. The reported 5-year survival rate of patients with SGT is 63.4%. Because this type of tumor develops in major bronchi, patients with SGT commonly present with symptoms of bronchial obstruction, including dyspnea, shortness of breath, wheezing, and coughing; thus, the tumor is usually identified at an early stage. Most patients are treated by lobectomy and pneumonectomy, but bronchoplasty or tracheoplasty is often needed to preserve respiratory function. Lymphadenectomy in the surgical resection of SGT is recommended, given that clinical benefit from lymphadenectomy has been reported in patients with MEC. For advanced tumors, appropriate therapy should be considered according to the subtype because of the varying clinicopathologic features. MEC, but not ACC, is less likely to be treated with radiation therapy because of its low response rate. Although previous researchers have learned much from studying SGT over the years, the diagnosis and treatment of SGT remains a complex and challenging problem for thoracic surgeons. In this article, we review the diagnosis, prognosis, and treatment (surgery, chemotherapy, and radiotherapy) of SGT, mainly focusing on MEC and ACC. We also summarize reports of adjuvant and definitive radiation therapy for ACC in the literature.
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Affiliation(s)
- Shinkichi Takamori
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Keiju Aokage
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Osaka, Japan
| | - Tomohiro Miyoshi
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Takahiro Mimae
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Makoto Endo
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Aritoshi Hattori
- Division of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Masaya Yotsukura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Isaka
- Department of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mitsuhiro Isaka
- Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tomohiro Maniwa
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Ryu Nakajima
- Division of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Shun-Ichi Watanabe
- Division of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
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Xia Y, He X. Adenoid cystic carcinoma with high-grade transformation. Pathology 2024; 56:136-138. [PMID: 37718144 DOI: 10.1016/j.pathol.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/16/2023] [Indexed: 09/19/2023]
Affiliation(s)
- Yan Xia
- Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xianglei He
- Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Gou WB, Yang YQ, Song BW, He P. Solid basal adenoid cystic carcinoma of the breast: A case report and literature review. Medicine (Baltimore) 2024; 103:e37010. [PMID: 38241532 PMCID: PMC10798743 DOI: 10.1097/md.0000000000037010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/29/2023] [Indexed: 01/21/2024] Open
Abstract
RATIONALE Adenoid cystic carcinoma (AdCC) is a rare malignancy of the breast with a low Ki-67 index and good prognosis. Owing to the rarity of breast AdCC, the misdiagnosis rate is as high as 50%, and there is no consensus or recognized guidelines for the treatment of this disease. Therefore, it is necessary to conduct a detailed clinical and pathological analysis in combination with a literature review to improve our understanding, diagnosis, and treatment of the disease. METHODS A 68-year-old woman sought medical attention due to a recently increasing mass in the breast. The left breast mass was 1.3 cm × 1 cm in size. We analyzed the morphology, immunohistochemistry, and molecular characteristics of the tumor removed by surgery, and reviewed relevant literature. DIAGNOSES Solid basal AdCC of the breast. INTERVENTIONS We performed biopsy, immunohistochemistry and molecular testing on surgical resection specimens. OUTCOMES Combining morphological and immunohistochemical features, it is consistent with solid basal AdCC of the breast, and Fish detected MYB gene break. LESSONS Due to the high misdiagnosis rate of AdCC, accurate histopathological diagnosis is particularly important. At present, breast conserving surgery and local tumor resection are mainly used for the treatment of breast AdCC, and postoperative adjuvant radiotherapy is feasible.
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Affiliation(s)
- Wen Bin Gou
- Department of Pathology, People’s Hospital of Wanning, Wanning, Hainan, China
| | - Yong Qiang Yang
- Department of Endoscopy, People’s Hospital of Wanning, Wanning, Hainan, China
| | - Bei Wen Song
- Department of Endoscopy, People’s Hospital of Wanning, Wanning, Hainan, China
| | - Pei He
- Department of Clinical laboratory, Xinjiang Production and Construction Corps Sixth Division Hospital, Wujiaqu, Xinjiang, China
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Singh A, Prasad P, Singh A, Siddique MI. Submandibular Gland Adenoid Cystic Carcinoma Presenting as Intracranial Metastasis. Neurol India 2024; 72:155-157. [PMID: 38443021 DOI: 10.4103/ni.ni_1260_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 11/14/2023] [Indexed: 03/07/2024]
Affiliation(s)
- Anurag Singh
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Swid MA, Li L, Drahnak EM, Idom H, Quinones W. Updated Salivary Gland Immunohistochemistry: A Review. Arch Pathol Lab Med 2023; 147:1383-1389. [PMID: 37074867 DOI: 10.5858/arpa.2022-0461-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 04/20/2023]
Abstract
CONTEXT.— Salivary gland neoplasms are rare lesions in the head and neck (H&N) pathology realm. There are more than 20 malignant and 15 benign salivary gland neoplasms in the 5th edition of the World Health Organization classification of H&N tumors. These neoplasms consist of heterogeneous groups of uncommon diseases that make diagnosis and treatment challenging for the clinical team. Using an algorithmic immunohistochemical approach-defined tumor origin and type has proven to be effective and advantageous. Immunohistochemistry may be used as sort of a "diagnostic looking glass," not as a positive or negative type tool, but as an indispensable complement to a hematoxylin-eosin morphologic pattern-based approach. Furthermore, the understanding of the novel discoveries of the salivary gland gene fusions and the molecular aspects of these tumors makes the process easier and improve the diagnosis as well as treatment aspects. This review reflects our experience with more recent diagnostic antibodies, which include MYB RNA, Pan-TRK, PLAG1, LEF1, and NR4A3. Each of these is linked with a specific type of neoplasm; for example, gene fusions involving the PLAG1 and HMGA2 oncogenes are specific for benign pleomorphic adenomas, and MYB is associated with adenoid cystic carcinoma. OBJECTIVE.— To review these more recent antibodies, which highly enhance salivary gland neoplasm diagnosis. DATA SOURCES.— The study sources involved literature PubMed searches, including multiple review articles, case reports, selected book chapters, and Geisinger Medical Center cases. CONCLUSIONS.— Salivary gland tumors are a rare, varied group of lesions in H&N pathology. We need to have continuous readings and revisions of the molecular consequences of these fusion oncoproteins and their subsequent targets, which will eventually lead to the identification of novel driver genes in salivary gland neoplasms.
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Affiliation(s)
- Mohammed Amer Swid
- From Laboratory Medicine and Pathology, Geisinger Medical Center, Danville, Pennsylvania (Swid, Li, Quinones)
| | - Liping Li
- From Laboratory Medicine and Pathology, Geisinger Medical Center, Danville, Pennsylvania (Swid, Li, Quinones)
| | | | - Hayden Idom
- Fordham University, New York, New York (Idom)
| | - William Quinones
- From Laboratory Medicine and Pathology, Geisinger Medical Center, Danville, Pennsylvania (Swid, Li, Quinones)
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Brajkovic D, Kiralj A, Mijatov I, Ilic M. Pathological nodal status as a main predictive factor of survival and treatment outcomes of submandibular salivary gland cancers: A 25-year single center experience. J Stomatol Oral Maxillofac Surg 2023; 124:101462. [PMID: 37003413 DOI: 10.1016/j.jormas.2023.101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Aim of this study was to explore the survival predictive factors and treatment outcomes in a cohort of SGC patients treated at a single center over a period of 25 years. MATERIALS AND METHODS Patients who had received primary treatment for SGC were enroled. Outcomes evaluated were: overall survival (OS), disease specific survival (DSS), recurrence free survival (RFS), locoregional recurrence free survival (LRFS) and distant metastasis free survival (DFS). RESULTS A total of 40 patients with SGC were enroled in the study. The most common tumor was the adenoid cystic carcinoma (60% of cases). Cumulative OS for 5-and 10-year follow up period was 81% and 60%, respectively. Thirteen patients (32.5%) developed distant metastases during follow-up. Nodal status, high-grade histology, tumor stage and adjuvant radiation-therapy (RT) were significant variables on multivariate analysis for survival and treatment outcomes. CONCLUSIONS Submandibular gland carcinomas represent rare and heterogenous tumor group regarding histological appearance and locoregional and distant metastatic potential. Tumor histological grade, AJCC tumor stage and nodal status were the strongest predictive factors for survival and treatment outcomes. RT improved OS and locoregional treatment outcome, but not DFS. Elective neck dissection (END) could be beneficial for selected cases of SGC. Superselective neck dissection of levels I-IIa may be the level of dissection for END. Distant metastases were the main cause of death and treatment failure. Prognostic factors for poor DMFS were AJCC stage III and IV, high tumor grade and nodal status.
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Affiliation(s)
- Denis Brajkovic
- Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Novi Sad, Serbia; Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia.
| | - Aleksandar Kiralj
- Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Novi Sad, Serbia; Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia
| | - Ivana Mijatov
- Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Novi Sad, Serbia; Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia
| | - Miroslav Ilic
- Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Novi Sad, Serbia; Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia
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Yadav U, Mahendru R, Sharma J, Kakkar A. Diagnosis of Adenoid Cystic Carcinoma with Striking Tubular Hypereosinophilia by MYB and EWSR1 Breakapart Fluorescence In Situ Hybridization. Head Neck Pathol 2023; 17:940-951. [PMID: 38010473 PMCID: PMC10739655 DOI: 10.1007/s12105-023-01596-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/24/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Adenoid cystic carcinoma (AdCC), associated with MYB/MYBL1 gene rearrangements, shows epithelial and basaloid myoepithelial cells arranged in tubular, cribriform and solid patterns. Variations from this classic morphology make diagnosis challenging, necessitating molecular testing. AdCC with striking tubular hypereosinophilia (AdCC-STE) is one such recently described histological subtype. METHODS A 52-year-old female presented with a floor of mouth swelling for two months, diagnosed elsewhere as polymorphous adenocarcinoma (PAC). A biopsy was obtained. With a diagnosis of oncocytic neoplasm, wide excision of the tumor was undertaken. Histological examination, fluorescence in situ hybridization (FISH) and ultrastructural examination were performed. Archival cases of PAC and epithelial myoepithelial carcinoma (EMC) were reviewed, and MYB immunostaining and FISH were performed to identify potential AdCC-STE cases. RESULTS The excised tumor from the index patient showed bilayered tubules, micropapillae and cribriform pattern. Luminal cells with hypereosinophilic to clear cytoplasm were surrounded by flattened abluminal cells. Focally, basophilic matrix was seen within sharply demarcated pseudocystic spaces. FISH revealed MYB and EWSR1 gene rearrangements, confirmatory of AdCC-STE. Electron microscopy showed features consistent with AdCC; however, mitochondria were not prominent. Among 14 archival PACs, two showed MYB immunopositivity; one showed MYB rearrangement but was classical AdCC. Among 35 EMC, one case showed MYB immunoreactivity and eosinophilia of luminal cells but lacked MYB/MYBL1 rearrangement. CONCLUSION Awareness of unusual histological subtypes of AdCC, such as AdCC-STE, is imperative, as it may be misdiagnosed as PAC and EMC, among others. Presence of basophilic matrix and squamoid morules in a biphasic tumor even with hypereosinophilic rather than basaloid myoepithelial appearance should raise suspicion for AdCC-STE, and prompt molecular testing for confirmation. With wider accessibility, lower cost and significantly shorter turn-around-time when compared to RNA sequencing, FISH can be employed for confirmation of diagnosis, especially in low- and middle-income countries.
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Affiliation(s)
- Urvashi Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ria Mahendru
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Jyoti Sharma
- Department of Surgical Oncology, National Cancer Institute - All India Institute of Medical Sciences, Jhajjar, 124105, India
| | - Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Zhong C, Li H, Huang J, Li S, Ma J, Lin J, Wang G, Li S. The Novel Application of Robotic-Assisted Bronchoscopy Combined with Photodynamic Therapy for Adenoid Cystic Carcinoma of the Trachea. Respiration 2023; 102:961-968. [PMID: 37866356 DOI: 10.1159/000534352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/14/2023] [Indexed: 10/24/2023] Open
Abstract
Robotic platforms have been widely used in the various fields of clinical diagnosis and therapy of diseases in the past decade. Robotic-assisted bronchoscopy (RAB) demonstrates its advantages of visibility, flexibility, and stability in comparison to conventional bronchoscopic techniques. Improving diagnostic yield and navigation yield for peripheral pulmonary lesions has been defined; however, RAB platform of treatment was not reported. In this article, we report a case of a 52-year-old woman who was diagnosed with the tracheal adenoid cystic carcinoma and recurred in the second postoperative year, leading to the involvement of the entire tracheal wall and lumen obstruction. Since the lesion was inoperable, we combined RAB and photodynamic therapy (PDT) for the patient. The potential advantages of using RAB for PDT delivery include precise light irradiation of target lesions and stable intra-operative control over the long term. This is a novel application of RAB combined with PDT for airway diseases. The case report may provide a new insight into the diagnosis and treatment of pulmonary diseases. In addition to improving the diagnostic rates, the RAB platform may also play an important role in the treatment of airway and lung disease in the future.
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Affiliation(s)
- Changhao Zhong
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Hongjia Li
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,
| | - Junfeng Huang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuben Li
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiajun Ma
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Jinsheng Lin
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guangzhi Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Shiyue Li
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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赵 九, 李 珂, 韩 晓, 石 照, 曾 宪, 张 相. [Misdiagnosis of adenoid cystic carcinoma of oropharynx: a case report]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:837-839. [PMID: 37828891 PMCID: PMC10803242 DOI: 10.13201/j.issn.2096-7993.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Indexed: 10/14/2023]
Abstract
Adenoid cystic carcinoma usually occurs in the salivary glands of the head and neck. It is a malignant tumor with a high degree of malignancy, resistance to radiotherapy and chemotherapy and poor prognosis. The clinical course of adenoid cystic carcinoma is slow and easy to be misdiagnosed. The main diagnosis and treatment means are individualized and precise treatment under the multi-disciplinary consultation mode, that is, surgical treatment and radiotherapy and chemotherapy. Adenoid cystic carcinoma is prone to relapse and hematologic metastasis, and the traditional radiotherapy and chemotherapy based therapies have not achieved satisfactory efficacy in the past three decades. How to detect, diagnose and treat early is an urgent task faced by clinicians.
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Affiliation(s)
- 九洲 赵
- 深圳市耳鼻咽喉研究所 深圳市龙岗区耳鼻咽喉医院头颈外科(广东深圳,518172)Department of Head and Neck Surgery, Shenzhen Otolaryngology Research Institute, Shenzhen Longgang ENT Hospital, Shenzhen, 518172, China
| | - 珂 李
- 深圳市耳鼻咽喉研究所 深圳市龙岗区耳鼻咽喉医院头颈外科(广东深圳,518172)Department of Head and Neck Surgery, Shenzhen Otolaryngology Research Institute, Shenzhen Longgang ENT Hospital, Shenzhen, 518172, China
| | - 晓东 韩
- 深圳市耳鼻咽喉研究所 深圳市龙岗区耳鼻咽喉医院影像科Department of Imaging, Shenzhen Otolaryngology Research Institute, Shenzhen Longgang ENT Hospital
| | - 照辉 石
- 深圳市耳鼻咽喉研究所 深圳市龙岗区耳鼻咽喉医院鼻颅底外科Department Nasal Skull Base Surgery, Shenzhen Otolaryngology Research Institute, Shenzhen Longgang ENT Hospital
| | - 宪海 曾
- 深圳市耳鼻咽喉研究所 深圳市龙岗区耳鼻咽喉医院头颈外科(广东深圳,518172)Department of Head and Neck Surgery, Shenzhen Otolaryngology Research Institute, Shenzhen Longgang ENT Hospital, Shenzhen, 518172, China
| | - 相民 张
- 深圳市耳鼻咽喉研究所 深圳市龙岗区耳鼻咽喉医院头颈外科(广东深圳,518172)Department of Head and Neck Surgery, Shenzhen Otolaryngology Research Institute, Shenzhen Longgang ENT Hospital, Shenzhen, 518172, China
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14
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Zhou B, Duan T, Liu X, Peng L. A cytodiagnosis of adenoid cystic carcinoma of the tracheobronchial tree through a systematic clinical case comparison and analysis. BMC Pulm Med 2023; 23:334. [PMID: 37684618 PMCID: PMC10492350 DOI: 10.1186/s12890-023-02628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Primary adenoid cystic carcinoma (AdCC) of the tracheobronchial tree is very rare with a high risk for recurrence and metastasis. The diagnosis of AdCC by histologic and immunohistochemical means has been well studied clinically. However, the identification of AdCC by cytologic features remains elusive due to the atypical features the cancer presents. This study aimed to describe the cytologic features of AdCC by using bronchial brushing, which could aid in distinguishing AdCC from other pulmonary carcinomas. METHODS The cytopathological features of bronchial brushing smears collected from seven cases were histologically diagnosed as AdCC. The defined cytologic features, which could potentially be diagnostic, were systemically analyzed. RESULTS Four out of the seven cytologic cases were inconcordance with the histologic diagnosis and cytologically classified as positive for malignant cells, small cell carcinoma, or atypical cells. Three cases showed a characteristic adenoid structure and magenta stroma forming globule, which was distinguished from the four cases. Cytologically, the above mentioned three cases were uniform with relatively small bland nuclei and little cytoplasm. In this study, only one case showed atypical polygonal medium-sized cells with conspicuous nucleoli. CONCLUSIONS Unlike fine-needle aspiration cytology, magenta stroma globules might offer an alternate clue for cytodiagnosis of AdCC clinically. Bronchial brushings cytology was more present in bland uniform cells with high nuclear to cytoplasmic ratios and background mucoid substance. More cases should be collected and confirmed using histopathology with careful film reading to reduce the rate of misdiagnosis.
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Affiliation(s)
- Bing Zhou
- Department of Pathology, The Second Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, 332005, China
| | - Ting Duan
- Department of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 314408, China
| | - Xianwei Liu
- Department of General Surgery, Jiujiang No.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Lizi Peng
- Department of Pathology, Jiujiang No.1 People's Hospital, 48#, Taling Road, Jiujiang, Jiangxi, 332000, China.
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15
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Girvin F, Phan A, Steinberger S, Shostak E, Bessich J, Zhou F, Borczuk A, Brusca-Augello G, Goldberg M, Escalon J. Malignant and Benign Tracheobronchial Neoplasms: Comprehensive Review with Radiologic, Bronchoscopic, and Pathologic Correlation. Radiographics 2023; 43:e230045. [PMID: 37561643 DOI: 10.1148/rg.230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Tracheobronchial neoplasms are much less common than lung parenchymal neoplasms but can be associated with significant morbidity and mortality. They include a broad differential of both malignant and benign entities, extending far beyond more commonly known pathologic conditions such as squamous cell carcinoma and carcinoid tumor. Airway lesions may be incidental findings at imaging or manifest with symptoms related to airway narrowing or mucosal irritation, invasion of adjacent structures, or distant metastatic disease. While there is considerable overlap in clinical manifestation, imaging features, and bronchoscopic appearances, an awareness of potential distinguishing factors may help narrow the differential diagnosis. The authors review the epidemiology, imaging characteristics, typical anatomic distributions, bronchoscopic appearances, and histopathologic findings of a wide range of neoplastic entities involving the tracheobronchial tree. Malignant neoplasms discussed include squamous cell carcinoma, malignant salivary gland tumors (adenoid cystic carcinoma and mucoepidermoid carcinoma), carcinoid tumor, sarcomas, primary tracheobronchial lymphoma, and inflammatory myofibroblastic tumor. Benign neoplasms discussed include hamartoma, chondroma, lipoma, papilloma, amyloidoma, leiomyoma, neurogenic lesions, and benign salivary gland tumors (pleomorphic adenoma and mucous gland adenoma). Familiarity with the range of potential entities and any distinguishing features should prove valuable to thoracic radiologists, pulmonologists, and cardiothoracic surgeons when encountering the myriad of tracheobronchial neoplasms in clinical practice. Attention is paid to any features that may help render a more specific diagnosis before pathologic confirmation. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Francis Girvin
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Alexander Phan
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Sharon Steinberger
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Eugene Shostak
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Jamie Bessich
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Fang Zhou
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Alain Borczuk
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Geraldine Brusca-Augello
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Margaret Goldberg
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
| | - Joanna Escalon
- From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.)
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Liang M, Yu Z, Wang F. A case report: An unusual presentation of adenoid cystic carcinoma of the lacrimal gland. Medicine (Baltimore) 2023; 102:e33446. [PMID: 37000056 PMCID: PMC10063268 DOI: 10.1097/md.0000000000033446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
RATIONALE Adenoid cystic carcinoma (ACC) is the most common malignant epithelial tumor of the lacrimal gland with the highest malignant degree. ACC of the lacrimal gland is characterized by symptoms of <1 years duration. We present a 38-year-old male patient who complained of an enlarging mass in the left lacrimal fossa for almost 10 years previous to the diagnosis of ACC. PATIENT CONCERNS A 38-year-old male patient visited our ophthalmology clinic with a chief complaint of a mass in his left upper lid, which had enlarged significantly over the previous months. DIAGNOSES Magnetic resonance imaging with intravenous Gadobutrol showed moderate and homogenous mass enhancement. Bone destruction is found. The periosteum is not eroded. The magnetic resonance imaging finding was supportive for malignancy. Histopathological examination of the specimen revealed solid tumor showing a cribriform pattern mixed small amount of basaloid cell proliferation. Therefore, the final diagnose was Adenoid cystic carcinoma of the lacrimal gland. INTERVENTIONS The treatment included en bloc resection of the mass and adjacent bone and radiotherapy. OUTCOMES In 1 year follow-up after operation, there is no recurrence. Visual acuity is 30/30. The left eye shows limitation on abduction. LESSONS The present case demonstrates an unusual progression of ACC of the Lacrimal Gland.
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Affiliation(s)
- Meiqin Liang
- Department of Ophthalmology, Changzhi People’s Hospital, Changzhi, China
| | - Zhirui Yu
- Department of Ophthalmology, Changzhi People’s Hospital, Changzhi, China
| | - Feng Wang
- Department of Ophthalmology, Changzhi People’s Hospital, Changzhi, China
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Fuoco J, Dong M, MacMillan C, Kak I, Perez-Ordonez B, Bradley G, Xu W, Magalhaes M. A 10-Year Review of Intraoral Salivary Gland Tumor Diagnoses: Diagnostic Challenges and Inter-Observer Agreement. Head Neck Pathol 2023; 17:193-203. [PMID: 36171535 PMCID: PMC10063724 DOI: 10.1007/s12105-022-01487-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Salivary gland tumors (SGT) are a diverse group of neoplasms arising from the major and minor glands. The oral cavity is the most common site for minor SGT (IMSGT), and these lesions frequently pose a challenge to the pathologist due to overlapping histopathological features and limited material for analysis. Our objective was to determine specific clinical and histopathological features associated with challenges in IMSGT diagnoses and pathologists' agreement. METHODS We conducted a retrospective analysis of 248 IMSGT received between 2010 and 2019. We evaluated the diagnostic challenge of the cases by stratifying according to whether a definitive, favored, or indeterminate (challenging) diagnosis was provided. Inter-observer agreement and concordance of biopsy diagnoses with the final diagnoses after tumor resection were evaluated. RESULTS Of the 248 biopsies, 191 had a definitive diagnosis, 38 favored diagnoses, and 19 were indeterminate. The predominant diagnoses considered for the indeterminate category were pleomorphic adenoma/myoepithelioma (PA), polymorphous adenocarcinoma (PAC), adenoid cystic carcinoma (AdCC), and low-grade adenocarcinoma. Using multivariate analysis of clinical features, younger patient age, smaller tumor size, and larger biopsy size increased the likelihood of a definitive diagnosis (p = 0.014, p = 0.037, p = 0.012). The inter-observer agreement for 68 representative cases was moderate overall (Fleiss's Kappa 0.575) and good for the 40 cases with a definitive diagnosis (Fleiss's Kappa 0.66). Sixty-five biopsy diagnoses were matched with corresponding tumor resection diagnoses and found to show a good concordance (Cramer's V test 0.76). The discordant diagnoses predominantly involved PA, carcinoma exPA, PAC, AdCC, and adenocarcinoma NOS. CONCLUSION Diagnostic challenges in IMSGT incisional biopsies were infrequent, especially if multiple pathologists were consulted. PA, PAC, AdCC, and adenocarcinoma NOS were the histologic types more commonly posing diagnostic challenges. Younger patient age, smaller tumor size, and larger biopsy are associated with a definitive diagnosis. This data highlights the importance of appropriate sampling in IMSGT.
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Affiliation(s)
- Jessie Fuoco
- Oral & Maxillofacial Pathology & Oral Medicine, University of Toronto, 457-124 Edward Street, M5G 1G6, Toronto, ON, Canada
| | - Mei Dong
- Department of Biostatistics, University Health Network, Princess Margaret Hospital, Toronto, ON, Canada
| | - Christina MacMillan
- Department of Laboratory Medicine & Pathobiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ipshita Kak
- Department of Laboratory Medicine & Pathobiology, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Bayardo Perez-Ordonez
- Department of Laboratory Medicine & Pathobiology, University Health Network, Toronto, ON, Canada
| | - Grace Bradley
- Oral & Maxillofacial Pathology & Oral Medicine, University of Toronto, 457-124 Edward Street, M5G 1G6, Toronto, ON, Canada
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Wei Xu
- Department of Biostatistics, University Health Network, Princess Margaret Hospital, Toronto, ON, Canada
| | - Marco Magalhaes
- Oral & Maxillofacial Pathology & Oral Medicine, University of Toronto, 457-124 Edward Street, M5G 1G6, Toronto, ON, Canada.
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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18
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Dudde F, Barbarewicz F, Kruger C, Henkel KO. Fulminant Adenoid Cystic Carcinoma of the Maxillary Sinus - A Rare Finding: Case Report. In Vivo 2023; 37:904-907. [PMID: 36881100 PMCID: PMC10026643 DOI: 10.21873/invivo.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The most common malignant tumor of the small salivary glands in the head and neck region is adenoid cystic carcinoma (ACK). The most common localization of ACK is the hard palate. ACK does not show any sex predisposition and is mainly diagnosed in middle-aged patients. CASE REPORT The present case report describes a fulminant ACK in the rare localization of maxillary sinus in a 36-year old male. The subsequent surgical treatment consisted of a radical hemimaxillectomy using an extraoral approach according to Weber-Fergusson-Dieffenbach and ipsilateral neck dissection. A magnetic epithesis was used for initial defect coverage of the maxillary bone accompanied by an obturator prosthesis. The surgical treatment was then followed by adjuvant proton therapy. CONCLUSION This case report shows how individual patient care can be provided according to the latest therapy standards of ACK in the rare localization of the maxillary sinus.
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Affiliation(s)
- Florian Dudde
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany;
| | - Filip Barbarewicz
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Christina Kruger
- Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Kai-Olaf Henkel
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
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Abstract
RATIONALE Adenoid cystic carcinoma (ACC) often occurs in the major and minor salivary glands and other sites containing secretory glands, while ACC of the Bartholin's gland (BG-ACC) in the vulva is rare and easily misdiagnosed. PATIENT CONCERNS A 58-year-old female was referred to our hospital for further valuation of a mass occurring on the left side of her vulva. In the other hospital, the beginning of the period, local ultrasound showed a vulva mass, which was suspected to be a Bartholin's gland cyst. Mixed neoplasms were considered in some biopsies. When transferred to our hospital, virtuous tumors were considered by ultrasound and magnetic resonance imaging. Pathology initially considered benign hyperplastic active tumor or borderline tumor. DIAGNOSES Histological, immunochemical, and molecular tests confirmed a diagnosis of BG-ACC, negative surgical margin, without lymphatic metastasis. INTERVENTIONS Extended excision of the mass at left labia majora plus left inguinal lymph node dissection was performed. OUTCOMES The patient received surgery therapy, no recurrence was observed during a 18-month follow-up period. LESSONS Due to its lack of specific characteristics in clinical, ultrasound and imaging, it is easy to be misdiagnosed, Due to its rarity and nonspecific clinical, radiologic and ultrasonographic manifestations, BG-ACC can be easily misdiagnosed. And its pathomorphological features overlap with other benign and malignant tumors occurring at vulva, BG-ACC can be easily misdiagnosed, and diagnosis by puncture biopsy is extremely difficult. Use of paraffin sections to identify tumor growth characteristics, combined with immunohistochemical findings, is the key to the diagnosis of ACC. In rare sites, MYB gene split are helpful in making a definite diagnosis.
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Affiliation(s)
- Wenhui Wang
- Department of Pathology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Hao Chen
- Department of Pathology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Hualei Guo
- Department of Pathology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Lei Chen
- Department of Ultrasound, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Miaoping Zhu
- Department of Radiology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Yingjia Zhu
- Department of Gynecology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
- *Correspondence: Yingjia Zhu, Department of Gynecology, Hangzhou Women’s Hospital, 369 Kunpeng Road, Shangcheng District, Hangzhou 310008, China (e-mail: )
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20
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Ribeiro EA, Harvey S, Wakely PE, Ali SZ. Metastatic salivary gland neoplasms to pleural effusion: diagnostic challenges and prognostic significance in a series with 9 patients. J Am Soc Cytopathol 2022; 11:359-367. [PMID: 36123248 DOI: 10.1016/j.jasc.2022.07.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/17/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Pleural effusions can present a diagnostic challenge as they are not always caused by malignancy in patients with a history of typical visceral primaries. MATERIAL AND METHODS At 2 major academic medical centers, we have identified several cases in which salivary gland neoplasms metastasized to pleural effusions in patients who have been aggressively managed with various treatment modalities including chemotherapy, radiation, and/or surgical excision. RESULTS Herein, we present a range of primary salivary gland tumors that metastasized to serous effusions and characterize their cytomorphology, immunoprofiles, and clinical courses. Our case series shows that many tumor types metastasize to pleural effusions and they present unique diagnostic challenges in each case. We found that metastasis of a salivary gland neoplasm to a pleural effusion is a late-stage event and is often associated with poor prognosis. CONCLUSIONS This series serves as a resource to demonstrate the cytomorphologic and immunohistochemical features of malignant pleural effusions due to salivary gland neoplasms and draws attention to poor prognosis in cases of salivary duct carcinoma, mucoepidermoid carcinoma and adenoid cystic carcinoma.
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Affiliation(s)
- Efrain A Ribeiro
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Samuel Harvey
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Paul E Wakely
- Department of Pathology, The Ohio State University, Columbus, Ohio
| | - Syed Z Ali
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.
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Ribeiro EA, Maleki Z. Cystic Salivary Gland Neoplasms: Diagnostic Approach With a Focus on Ancillary Studies. Adv Anat Pathol 2022; 29:365-372. [PMID: 36044380 DOI: 10.1097/pap.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cystic salivary gland cytology can be challenging due to the fact that a cystic mass can be the clinical presentation of both non-neoplastic and neoplastic conditions. Neoplastic lesions consist of both benign and malignant neoplasms. The cytomorphologic features of these entities can overlap and the cystic background may additionally contribute to the complexity of these lesions and their interpretation. Ancillary studies have been reported in several studies to be beneficial in further characterization of the cellular components and subsequent diagnosis of the cystic lesions of the salivary gland. Fluorescence in situ hybridization, real-time polymerase chain reaction, and next-generation sequencing are now being utilized to detect molecular alterations in salivary gland neoplasms. MALM2 rearrangement is the most common gene fusion in mucoepidermoid carcinoma. PLAG1 rearrangement is present in more than half of pleomorphic adenomas. AKT1:E17K mutation is the key diagnostic feature of the mucinous adenocarcinoma. NR4A3 overexpression is highly sensitive and specific for the diagnosis of acinic cell carcinoma. MYB fusion is noted in adenoid cystic carcinoma. ETV6:NTRK3 fusion is helpful in diagnosis of secretory carcinoma. p16 and human papillomavirus (HPV) studies differentiate HPV-related squamous cell carcinoma from non-HPV-related neoplasms with overlapping features. NCOA4:RET fusion protein is the main fusion in intraductal carcinoma.
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Affiliation(s)
- Efrain A Ribeiro
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, MD
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Abstract
Primary cystic adenoid skin carcinoma is a rare and poorly documented neoplasm in literature worldwide, with just over 250 reports. This work describes a 52-year-old male patient, with no comorbidities, who presented this neoplasm in nodular format in the posterior thoracic region, associated with localized pain and erythema - symptoms that led him to seek medical help. The clinical findings, differential diagnosis and treatment particularities were reviewed and correlated with the clinical case. The choice of type of surgical treatment was done considering the characteristics of the primary lesion that are associated with a worse prognosis. Despite its rarity, this neoplasm is easily identified through histological examination, the correct choice of treatment and patient follow-up, essential to increase survival. Thus, this work contributes to diminish the scarcity of literature related to this topic, especially the form of treatment employed.
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Affiliation(s)
- M Moreno
- Medicine School Department of Federal University of Fronteira Sul - UFFS, Chapecó City 89815-899, Brasil.
| | - Oliveira de
- Medicine School Department of Federal University of Fronteira Sul - UFFS, Chapecó City 89815-899, Brasil.
| | - I Czarnobai
- Medicine School Department of Federal University of Fronteira Sul - UFFS, Chapecó City 89815-899, Brasil.
| | - Boff Cássia
- Medicine School Department of Federal University of Fronteira Sul - UFFS, Chapecó City 89815-899, Brasil.
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Butcher MR, White MJ, Rooper LM, Argani P, Cimino-Mathews A. MYB RNA In Situ Hybridization Is a Useful Diagnostic Tool to Distinguish Breast Adenoid Cystic Carcinoma From Other Triple-negative Breast Carcinomas. Am J Surg Pathol 2022; 46:878-888. [PMID: 35522890 DOI: 10.1097/pas.0000000000001913] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Breast adenoid cystic carcinoma (AdCC) has overlapping features with basal-like triple-negative breast carcinoma (TNBC), yet carries a more favorable prognosis, and accurate diagnosis is critical. Like salivary gland AdCC, breast AdCC demonstrates recurrent alterations in the MYB gene. Novel chromogenic RNA in situ hybridization (ISH) for MYB has emerged as sensitive and specific for salivary gland AdCC. Here, we evaluate MYB RNA ISH in invasive ductal carcinomas (IDCs) including basal-like TNBC, and in the histologic mimics ductal carcinoma in situ (DCIS) and collagenous spherulosis. MYB RNA ISH was also performed on previously constructed tissue microarrays containing 78 evaluable IDC, including 30 basal-like TNBC (EGFR+ and/or CK5/6+), 19 luminal A (ER+/HER-2-), 12 HER-2+ (ER-/HER-2+), 11 non-basal-like TNBC, and 6 luminal B (ER+/HER-2+). MYB RNA ISH overexpression was seen in 100% (n=18/18) of primary breast AdCC and 10% (n=8/78) of IDC (P<0.0001). MYB RNA ISH was overexpressed in 37% (n=7/19) of luminal A and 8% (n=1/12) of HER-2+ IDC, and in no cases of TNBC or luminal B IDC. The majority (67%, n=8/12) of DCIS and all (n=7) cases of collagenous spherulosis demonstrated overexpression of MYB RNA. MYB gene rearrangement was detected in 67% (n=4/6) evaluable AdCC. Although MYB RNA ISH overexpression cannot be used to distinguish between cribriform DCIS or collagenous spherulosis and AdCC, MYB RNA ISH is absent in basal-like TNBC and rare in ER+ or HER-2+ IDC. MYB RNA ISH could be a useful, sensitive, and rapid diagnostic adjunct in the workup of a triple-negative carcinoma in the breast.
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Affiliation(s)
| | | | | | - Pedram Argani
- Departments of Pathology
- Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ashley Cimino-Mathews
- Departments of Pathology
- Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
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Zupancic M, Holzhauser S, Cheng L, Ramqvist T, Du J, Friesland S, Näsman A, Dalianis T. Analysis of Human Papillomavirus (HPV) and Polyomaviruses (HPyVs) in Adenoid Cystic Carcinoma (AdCC) of the Head and Neck Region Reveals Three HPV-Positive Cases with Adenoid Cystic-like Features. Viruses 2022; 14:v14051040. [PMID: 35632780 PMCID: PMC9144058 DOI: 10.3390/v14051040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/30/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
An aetiological role of human papillomavirus (HPV) and/or human polyomaviruses (HPyVs) has been proposed in adenoid cystic carcinoma (AdCC). Moreover, HPV-related multiphenotypic carcinoma (HMSC) was recently introduced as an emerging entity of the sinonasal region. Here, we primarily want to study the role of HPV/HPyV in a large AdCC cohort and, secondly, possibly identify and characterize HMSC. Tumour DNA from 68 patients initially diagnosed with AdCC between 2000 and 2012 was, therefore, tested for 27 HPV types and 10 HPyVs. HPV DNA-positive samples were micromorphologically re-evaluated, further stained for p16INK4a, S100, p63 and CD117 and tested for the presence of the MYB-NFIB fusion transcript. Notably, no samples were HPyV-positive, while one sinonasal and two tonsillar carcinomas were HPV- and p16-positive. After re-evaluating the micromorphology, immunohistochemistry and presence of fusion transcripts, all tumours had the same appearance and fitted within the diagnosis of HMSC, but in all these three cases, the morphology of the HMSC and basaloid squamous cell carcinoma was overlapping. We conclude that HPV and HPyV have no major role in AdCC. However, based on our data, we also suggest that HMSC should be considered as a basaloid variant of squamous cell carcinoma, and not its own entity, until better characterized.
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Affiliation(s)
- Mark Zupancic
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; (M.Z.); (S.H.); (T.R.); (S.F.); (A.N.)
- Department of Head-, Neck-, Lung- and Skin Cancer, Theme Cancer, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Stefan Holzhauser
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; (M.Z.); (S.H.); (T.R.); (S.F.); (A.N.)
| | - Liquin Cheng
- Department of Microbiology, Tumour Biology and Cell Biology, Karolinska Institutet, 17177 Stockholm, Sweden; (L.C.); (J.D.)
| | - Torbjörn Ramqvist
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; (M.Z.); (S.H.); (T.R.); (S.F.); (A.N.)
| | - Juan Du
- Department of Microbiology, Tumour Biology and Cell Biology, Karolinska Institutet, 17177 Stockholm, Sweden; (L.C.); (J.D.)
| | - Signe Friesland
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; (M.Z.); (S.H.); (T.R.); (S.F.); (A.N.)
- Department of Head-, Neck-, Lung- and Skin Cancer, Theme Cancer, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Anders Näsman
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; (M.Z.); (S.H.); (T.R.); (S.F.); (A.N.)
- Department of Clinical Pathology, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Tina Dalianis
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden; (M.Z.); (S.H.); (T.R.); (S.F.); (A.N.)
- Correspondence:
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25
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Sadeghi H, Saffar H, Taheri P, Yazdani F, Etebarian A. Prognostic Significance of Cancer Stem Cell Markers in Patients With Salivary Gland Carcinomas. Appl Immunohistochem Mol Morphol 2022; 30:284-290. [PMID: 35001035 DOI: 10.1097/pai.0000000000001006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/01/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Cancer stem cells (CSCs) are a small group of cells resistant to therapy and play a major role in tumor progression, recurrence, and poor clinical outcomes of patients. This study aimed to evaluate the association of CSC markers with clinicopathologic features and survival in patients with salivary gland carcinomas (SGCs). MATERIALS AND METHODS The medical records of 48 patients affected by mucoepidermoid carcinoma (MEC) and 47 patients with adenoid cystic carcinoma (AdCC) were reviewed retrospectively. SOX2, CD133, and CD44 expression was appraised by immunohistochemistry and statistically analyzed to weigh the correlation between these markers and patients' clinicopathologic features and tumor outcomes. RESULTS In AdCC patients showing poor outcomes, a trend toward a high expression of CD133 and CD44 and low expression of SOX2 was observed, while in MEC patients experiencing the same outcomes, there was a trend toward a high expression of CD44 and low expression of CD133 and SOX2. Only the increase of MEC histopathologic grade was statistically significant with decreased SOX2 expression. Distant metastasis in AdCC patients, tumor grade, lymph node involvement, and local recurrence in MEC patients had significant correlations with patients' survival. CONCLUSION Besides the significant association between low SOX2 expression and higher grades of MEC, we found no statistically significant correlation between the studied CSC markers and patients' survival or clinicopathologic features. Therefore, a larger sample size with long-term follow-up is beneficial for thorough investigations toward the main role of CSCs in patients with SGCs.
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Affiliation(s)
- Hanieh Sadeghi
- Student Research Committee, Alborz University of Medical Sciences
| | - Hana Saffar
- Pathology Department, Cancer Institute, Imam Khomeini Hospital Complex
| | - Pardis Taheri
- Student Research Committee, Alborz University of Medical Sciences
| | - Farzad Yazdani
- Pathology Department, Amir Alam Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Etebarian
- Oral and Maxillofacial Pathology Department, School of Dentistry, Alborz University of Medical Sciences, Karaj
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26
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Yaranal PJ, Bithun BK, Anand AS. Primary cutaneous adenoid cystic carcinoma - An onerous task for clinicians and pathologists. INDIAN J PATHOL MICR 2022; 65:459-461. [PMID: 35435395 DOI: 10.4103/ijpm.ijpm_1162_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is an uncommon malignant neoplasm usually confined to the salivary glands, lungs, and breasts. Primary cutaneous adenoid cystic carcinoma (PCACC) is an extremely rare entity with solitary cases reported at sites away from the scalp and chest. Hence, one must follow the multidisciplinary approach to exclude any primary ACC elsewhere in the body. We report a rare case of PCACC arising from the skin of the left lower limb in a 55-year-old woman with a history of recurrent swelling, clinically diagnosed as a metastatic tumor.
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Affiliation(s)
| | - B K Bithun
- Department of Pathoogy, Kannur Medical College, Kannur, Kerala, India
| | - A S Anand
- Department of Pathoogy, Navodaya Medical College, Raichur, Karnataka, India
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Cozzi S, Bardoscia L, Najafi M, Botti A, Blandino G, Augugliaro M, Manicone M, Iori F, Giaccherini L, Sardaro A, Iotti C, Ciammella P. Adenoid Cystic Carcinoma/Basal Cell Carcinoma of the Prostate: Overview and Update on Rare Prostate Cancer Subtypes. Curr Oncol 2022; 29:1866-1876. [PMID: 35323352 PMCID: PMC8947681 DOI: 10.3390/curroncol29030152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022] Open
Abstract
Adenoid cystic carcinoma/basaloid cell carcinoma of the prostate (ACC/BCC) is a very rare variant of prostate cancer with uncertain behavior. Few cases are reported in the literature. Data on treatment options are scarce. The aim of our work was to retrospectively review the published reports. Thirty-three case reports or case series were analyzed (106 patients in total). Pathological features, management, and follow-up information were evaluated. Despite the relatively low level of evidence given the unavoidable lack of prospective trials for such a rare prostate tumor, the following considerations were made: prostate ACC/BCC is an aggressive tumor often presenting with locally advanced disease and incidental diagnosis occurs during transurethral resection of the prostate for urinary obstructive symptoms. Prostate-specific antigen was not a reliable marker for diagnosis nor follow-up. Adequate staging with Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) should be performed before treatment and during follow-up, while there is no evidence for the use of Positron Emission Tomography (PET). Radical surgery with negative margins and possibly adjuvant radiotherapy appear to be the treatments of choice. The response to androgen deprivation therapy was poor. Currently, there is no evidence of the use of truly effective systemic therapies.
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Affiliation(s)
- Salvatore Cozzi
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Lilia Bardoscia
- Radiation Oncology Unit, S. Luca Hospital, Healthcare Company Tuscany Nord Ovest, 55100 Lucca, Italy
- Correspondence:
| | - Masoumeh Najafi
- Department of Radiation Oncology Shohadaye Haft-e-Tir Hospital, Iran University of Medical Science, Teheran 1449614535, Iran;
| | - Andrea Botti
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Gladys Blandino
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Matteo Augugliaro
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Moana Manicone
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Federico Iori
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Lucia Giaccherini
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Cinzia Iotti
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
| | - Patrizia Ciammella
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy or (S.C.); (G.B.); (M.A.); (M.M.); (F.I.); (L.G.); (C.I.); (P.C.)
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28
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Yu MD, Men CJ, Do H, Colevas AD, Lin JH, Egbert PR, Tse DT, Kossler AL. Genome Sequencing and Apoptotic Markers to Assess Treatment Response of Lacrimal Gland Adenoid Cystic Carcinoma to Intra-Arterial Cytoreductive Chemotherapy. Ophthalmic Plast Reconstr Surg 2022; 38:e44-e47. [PMID: 34798653 PMCID: PMC10838401 DOI: 10.1097/iop.0000000000002079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Adenoid cystic carcinoma of the lacrimal gland is an aggressive, malignant epithelial neoplasm. We report the case of a 30-year-old male with lacrimal gland adenoid cystic carcinoma treated with neoadjuvant intra-arterial chemotherapy through the internal carotid artery, followed by orbital exenteration and chemoradiation. Treatment response was evaluated using a novel combination of pre- and posttreatment genome sequencing coupled with immunohistochemical evaluation, which showed diffuse tumor apoptosis. A posttreatment decrease in variant allele frequency of the NOTCH1 mutation, and robust tumor cytoreduction on imaging, supports exploration of NOTCH1 analysis as a potential marker of cisplatin sensitivity. The use of genome sequencing and immunohistochemical evaluation could provide a more targeted therapeutic assessment of neoadjuvant intra-arterial chemotherapy in the management of lacrimal gland adenoid cystic carcinoma.
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Affiliation(s)
- Michael D. Yu
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, U.S.A
| | - Clara J. Men
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, U.S.A
| | - Huy Do
- Department of Interventional Neuroradiology, Stanford University, Stanford, California, U.S.A
| | - A. Dimitrios Colevas
- Department of Medicine (Oncology), Stanford University, Stanford, California, U.S.A
| | - Jonathan H. Lin
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, U.S.A
- Department of Pathology, Stanford University, Stanford, California, U.S.A
| | - Peter R. Egbert
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, U.S.A
- Department of Pathology, Stanford University, Stanford, California, U.S.A
| | - David T. Tse
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, U.S.A
| | - Andrea L. Kossler
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, U.S.A
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29
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Prieto Cuadra JD, Dawid de Vera MT, García Carrasco E, Hierro Martín MI. Adenoid cystic carcinoma with a leptomeningeal dissemination in a 'wash' pattern. BMJ Case Rep 2021; 14:e247155. [PMID: 34972782 PMCID: PMC8720991 DOI: 10.1136/bcr-2021-247155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/04/2022] Open
Abstract
A 39-year-old woman was referred to the neurology department due to headache, instability and difficulty walking for 5 months. Several ancillary tests were performed. The blood test showed leucocytosis and the cerebrospinal fluid revealed an increased total protein and glucose consumption. Other infections or autoimmune causes were excluded. The MRI showed non-specific brain and spinal cord lesions. Given the findings described, a differential diagnosis between granulomatous meningoencephalitis and primary tumour or metastasis was proposed. Empirical treatment with tuberculostatic agents and corticosteroids was started. The neurological state of the patient worsened, she fell into a non-responsive coma and died in few days. The clinical autopsy performed revealed an adenoid cystic carcinoma with involvement of the central nervous system that developed leptomeningeal dissemination along the spinal cord in a fluid 'wash' pattern.
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Affiliation(s)
- Juan Daniel Prieto Cuadra
- Department of Pathology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Maria Teresa Dawid de Vera
- Department of Pathology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Eva García Carrasco
- Department of Radiology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - M Isabel Hierro Martín
- Department of Pathology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
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30
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Anjum S, Sen S, Chosdol K, Bakhshi S, Kashyap S, Pushker N, Bajaj MS, Meel R, Sharma MC. Vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1 alpha (HIF-1ɑ) in lacrimal gland Adenoid cystic carcinoma: Correlation with clinical outcome. Ann Diagn Pathol 2021; 56:151846. [PMID: 34749048 DOI: 10.1016/j.anndiagpath.2021.151846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/19/2021] [Accepted: 10/23/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE VEGF and HIF-1α are important regulators of angiogenesis, overexpressed in various tumors. Lacrimal gland Adenoid cystic carcinoma (ACC) is a malignant tumor whose angiogenic properties remain unexplored. This study was designed to evaluate the expression of HIF-1α and VEGF in lacrimal gland ACC. METHODS VEGF and HIF-1α immunoexpression was undertaken in 30 lacrimal gland ACC cases. mRNA expression of VEGF and HIF-1α was analysed in 17 cases by quantitative real time PCR. The results obtained were correlated with clinicopathological features and survival of the patients to determine the prognostic significance. RESULTS Immunoexpression of HIF-1α and VEGF was seen in 36.6% and 46.6% ACC cases. HIF-1α expression showed significant association with advanced T-stage (P = 0.001) and VEGF with intracranial extension (P = 0.014) and solid histological pattern (P = 0.045). HIF-1α mRNA expression was seen in 29.4% cases and showed significant association with perineural invasion (P = 0.027). Recurrence occurred in 60%, distant metastasis in 20% and death in 20% cases. Survival analysis revealed that patients with HIF-1α, VEGF immunoexpression, solid histological pattern, perineural invasion, bone erosion, intracranial extension, metastasis, advanced T-stage, and exenteration had poor survival. On multivariate analysis VEGF immunoexpression (hazard ratio, 16.785; 95% confidence interval, 1.872-150.495; P = 0.012) was the most significant poor prognostic factor. CONCLUSIONS This study demonstrates that VEGF is a potential predictor for poor clinical outcome in lacrimal gland Adenoid cystic carcinoma.
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Affiliation(s)
- Shahzan Anjum
- Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sen
- Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Kunzang Chosdol
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr. Bhim Rao Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kashyap
- Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neelam Pushker
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mandeep Singh Bajaj
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Meel
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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31
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Low A, Kadir AJ, Wong KT, Choo MM. A Case of Neglected, Recurrent Adenoid Cystic Carcinoma of Parotid Gland. Ophthalmic Plast Reconstr Surg 2021; 37:e193. [PMID: 33795606 DOI: 10.1097/iop.0000000000001947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Adeline Low
- Department of Ophthalmology, University of Malaya Eye Research Centre, University of Malaya Medical Centre
| | - Azida Juana Kadir
- Department of Ophthalmology, University of Malaya Eye Research Centre, University of Malaya Medical Centre
| | - Kum Thong Wong
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - May May Choo
- Department of Ophthalmology, University of Malaya Eye Research Centre, University of Malaya Medical Centre
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32
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White K, Askeland R, Bohy K. A Rare Case of Primary Pulmonary Adenoid Cystic Carcinoma and the Diagnostic Challenges on Cytology. S D Med 2021; 74:329-331. [PMID: 34449997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Adenoid cystic carcinoma (ACC) is a malignancy that typically arises in the salivary gland, yet can occur in other anatomic sites, including the lung. Primary pulmonary ACC is rare and comprises approximately 0.04-0.2 percent of all lung cancers. These tumors have the potential to recur and metastasize and are refractory to chemotherapy and radiation. Though histopathologic features are identical to ACC seen in the salivary glands on tissue biopsy, diagnosis on cytology specimens is challenging, as cytopathologic features of this entity have not been collectively described due to its low incidence and limited reports of the disease. We report a case of primary pulmonary ACC in a 43-year-old female that was missed on cytology, but was recognized on subsequent transbronchial biopsy. The biopsy revealed a neoplasm with cribriform architecture composed of round myoepithelial cells with inconspicuous nucleoli (see Figures 3 and 4). When correlating with the cytology specimen, the rare clusters of monomorphic, round cells with hyperchromatic nuclei, small nucleoli, and increased nuclear to cytoplasmic ratio (see Figures 1 and 2) were supportive of ACC, based on findings described from other reported cases. A small amount of homogenous, eosinophilic hyaline material was also associated with the neoplastic cells (see arrows in Figure 1). This case emphasizes the need to continue documenting cases of primary pulmonary ACC to expand the medical literature and increase awareness of this rare neoplasm in order to allow for accurate identification in cytologic specimens, especially when tissue biopsy is not obtained.
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Affiliation(s)
- Karah White
- Pathology Residency Program, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Ryan Askeland
- Sanford Health Pathology Clinic, Sioux Falls, South Dakota
| | - Kimberlee Bohy
- Sanford Health Pathology Clinic, Sioux Falls, South Dakota
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33
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Tretiakow D, Mollin E, Skorek A. Palatine tonsil adenoid cystic carcinoma. Oral Oncol 2020; 115:105135. [PMID: 33376056 DOI: 10.1016/j.oraloncology.2020.105135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Dmitry Tretiakow
- Department of Otolaryngology, Medical University of Gdansk, Gdansk, Poland.
| | - Edward Mollin
- Department of Otolaryngology, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Skorek
- Department of Otolaryngology, Medical University of Gdansk, Gdansk, Poland
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34
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Chia N, Petersson F. Adenoid cystic carcinoma with dedifferentiation/expansion of the luminal cell component and preserved biphasic morphology - Early high-grade transformation. Ann Diagn Pathol 2020; 50:151650. [PMID: 33254086 DOI: 10.1016/j.anndiagpath.2020.151650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022]
Abstract
We present two patients (29 and 67 years) with histomorphologic and immunohistochemical evidence of early high-grade transformation of adenoid cystic carcinoma in the nasal cavity and floor of mouth, respectively. The component of early high-grade transformation was characterized by 1) selective expansion of the luminal (CK7+, c-kit+, p63-) cell component with severe cytologic atypia and significantly increased Ki-67 proliferation index, and 2) retained albeit attenuated abluminal (CK7-, c-kit-, p63+) cells, surrounding nests of high-grade luminal cells.
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Affiliation(s)
- Noel Chia
- Department of Pathology, National University Hospital, Singapore, 5 Lower Kent Ridge Road, Main Building Level 3, S(119074)
| | - Fredrik Petersson
- Department of Pathology, National University Hospital, Singapore, 5 Lower Kent Ridge Road, Main Building Level 3, S(119074).
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Barron M, Asaad A, Khan KA, Idaewor P, Salih A, Alkistawi F, Comez T, Salih V, Abdalla AS. Breast Adenoid Cystic Carcinoma in a patient with Previous Contra-lateral Breast Ductal Carcinoma in-situ: A Case Report. Chirurgia (Bucur) 2020; 115:511-519. [PMID: 32876025 DOI: 10.21614/chirurgia.115.4.511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 11/23/2022]
Abstract
Breast adenoid cystic carcinoma (BACC) is a rarely encountered malignant breast neoplasm with a favourable outcome, despite its triple-negative receptor status. It is comprising less than 0.1% of all breast cancers. The more usual primary site of the adenoid cystic carcinoma is seen in the salivary glands, however BACC prognosis is better than the one for salivary gland and also than that of other breast invasive carcinoma. BACC also known to have fewer lymph node metastases as well as fewer distant metastases, hereby we present 73 years old female with previous history of breast ductal carcinoma in-situ, then developed contralateral breast adenoid cystic carcinoma.
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Ferreira S, Conde Fernandes I, Coelho A, Selores M. Primary cutaneous adenoid cystic carcinoma of the abdomen: a rare entity. Dermatol Online J 2020; 26:13030/qt0q979406. [PMID: 32941724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023] Open
Abstract
Adenoid cystic carcinoma is a rare neoplasm that arises from secretory glands, most frequently from the salivary glands. Primary cutaneous adenoid cystic carcinoma is microscopically identical to adenoid cystic carcinoma developing at other tissues. Therefore, differentiating between a primary cutaneous adenoid cystic carcinoma and an extracutaneous adenoid cystic carcinoma with cutaneous metastases is pivotal to determine its prognosis and management. We describe a case of primary cutaneous adenoid cystic carcinoma on the abdomen that was successfully treated with wide excision.
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Affiliation(s)
- Sandra Ferreira
- Department of Dermatology, Centro Hospitalardo Porto, Porto.
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Yumeen S, Mirza FN, Mirza HN, Ko CJ, Cohen JM. Primary cutaneous adenoid cystic carcinoma: Characterizing US demographics, clinical course, and prognostic factors. J Am Acad Dermatol 2020; 85:245-247. [PMID: 32798575 DOI: 10.1016/j.jaad.2020.08.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/02/2020] [Accepted: 08/07/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Sara Yumeen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Humza N Mirza
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Christine J Ko
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.
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Abstract
Sinonasal adenoid cystic carcinoma is a rare malignancy characterized by an insidious growth pattern and a tendency for perineural spread along major and minor nerves, resulting in invasion of the skull base and intracranial extension. Therefore, many patients present with advanced disease and involvement of critical structures, making treatment difficult and potentially associated with high morbidity. Surgery represents the mainstay of treatment of the primary tumor. Complete resection of the tumor with negative margins, whenever feasible, is associated with better survival outcomes. However, in the case of extensive involvement of vital structures (e.g., carotid artery, cavernous sinus, optic nerve, Meckel's cave) or when radical surgery could seriously affect the patient's quality of life, a function-preserving subtotal removal of the tumor followed by irradiation can be proposed. The role of surgery is limited to a biopsy in unresectable lesions that are more suitable for non-surgical treatments (e.g., exclusive chemoradiation). Given the difficulty in obtaining negative margins and the propensity for submucosal and perineural spread, adjuvant radiotherapy is strongly recommended. Recently, heavy-particle radiotherapy using protons or carbon ions has emerged as a promising treatment with improved local control. Local failures (60%) and distant metastases (40%) are common and can occur even decades after definitive treatment. The 5-year overall survival ranges from 55 to 70% and it exceeds that of other sinonasal malignancies, but dramatically drops down at 10 years (40%) and further decreases at 20 years (15%). Therefore, a prolonged follow-up of at least 15 years, and possibly lifelong, is mandatory.
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Affiliation(s)
- Paolo Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Mario Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy,
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Nix JS, Rooper LM. Navigating small biopsies of salivary gland tumors: a pattern-based approach. J Am Soc Cytopathol 2020; 9:369-382. [PMID: 32660844 DOI: 10.1016/j.jasc.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 12/15/2022]
Abstract
Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a specific diagnosis is not feasible in all cases, a cautious and thoughtful approach to the differential diagnosis and a keen awareness of clinical consequences can facilitate the most complete and useful classification possible. In this review, we present a general strategy for the evaluation of small salivary biopsies, including consideration of clinical and radiographic information, systematic assessment of histologic patterns, and judicious use of immunohistochemistry and molecular studies. We then focus on the distinctive differential diagnoses raised by 6 specific histologic patterns: tubular and cribriform architecture, squamous differentiation, mucin and other secretions, high-grade cytology, epithelial and lymphoid elements, and oncocytic features. Throughout this systematic and pattern-based approach, we focus on practical and cost-effective strategies to overcome the most common diagnostic challenges in limited material.
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MESH Headings
- Artifacts
- Biomarkers, Tumor/metabolism
- Biopsy/methods
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Diagnosis, Differential
- Humans
- Immunohistochemistry/methods
- Mucins/biosynthesis
- Salivary Gland Neoplasms/diagnosis
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
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Affiliation(s)
- J Stephen Nix
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa M Rooper
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Adkins BD, Geromes A, Zhang LY, Chernock R, Kimmelshue K, Lewis J, Ely K. SOX10 and GATA3 in Adenoid Cystic Carcinoma and Polymorphous Adenocarcinoma. Head Neck Pathol 2020; 14:406-411. [PMID: 31222589 PMCID: PMC7235140 DOI: 10.1007/s12105-019-01046-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 06/10/2019] [Indexed: 10/26/2022]
Abstract
Differentiating between adenoid cystic carcinoma (AdCC) and polymorphous adenocarcinoma (PAC) can be difficult on small biopsies and cytologic specimens. As such, further characterization of their immunophenotype may aid in distinction. Previous studies have found AdCC to be SOX10+/GATA3 variable and PAC to be GATA3 negative. SOX10 expression in PAC has, as yet, not been established. We performed GATA3 and SOX10 immunohistochemistry on whole sections of 25 cases each of AdCC and PAC (including both classic PAC and the cribriform variant) to assess whether these markers are of diagnostic utility in distinguishing between these entities. SOX10 was found to be positive in 100% of PAC and AdCC whereas GATA 3 was immunoreactive in 45% of AdCCs and 20% of PAC. While this is the first series to compare SOX10 and GATA3 staining in these two tumor types, their frequent expression and similar staining patterns render them of limited value in discriminating between these neoplasms.
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Affiliation(s)
- Brian D Adkins
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN CC3322, Nashville, TN, 37232-2561, USA
| | - Ariana Geromes
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN CC3322, Nashville, TN, 37232-2561, USA
| | - Lily Y Zhang
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rebecca Chernock
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Katherine Kimmelshue
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN CC3322, Nashville, TN, 37232-2561, USA
| | - James Lewis
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN CC3322, Nashville, TN, 37232-2561, USA
| | - Kim Ely
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN CC3322, Nashville, TN, 37232-2561, USA.
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Chen SL, Huang SF, Ho VWY, Chuang WY, Chan KC. Clinical characteristics and treatment outcome of adenoid cystic carcinoma in the external auditory canal. Biomed J 2020; 43:189-194. [PMID: 32389593 PMCID: PMC7283548 DOI: 10.1016/j.bj.2019.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/19/2019] [Accepted: 07/30/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study reviewed the clinical manifestations, pathological findings, and treatment outcomes of adenoid cystic carcinoma (ACC) in the external auditory canal (EAC). METHODS This was a retrospective review of 12 patients with a diagnosis of ACC in the EAC seen in a single institution over a 30-year period. Data on the demographics, clinical presentation, treatment strategy, and outcome, as well as the pathological features of ACC, were reviewed and analyzed. RESULTS The male-to-female ratio was 1:3 and the mean patient age was 55.9 years. The most common clinical presentation was otalgia (75%). Ten patients underwent surgical interventions, including radical mastoidectomy in five patients, wide excision in three, and lateral temporal bone resection in two. Adjuvant radiotherapy or concurrent chemoradiotherapy (CCRT) was performed in case of incomplete resection. Two patients underwent non-surgical treatments: radiotherapy in one and CCRT in the other. Microscopic perineural invasion was not associated with otalgia or histological subtype. The mean follow-up period was 84.6 months. Local recurrence occurred in 33% of patients. One-quarter of patients had distant metastasis, and all had lung metastasis. The 5-year overall survival rate for these patients was 82.5%. CONCLUSION EAC ACC should be included in the differential diagnosis when a patient presents with otalgia and a mass in EAC for more than 6 months, particularly if the patient is a middle-aged female. Otalgia might not be associated with perineural invasion or histological subtype. The lung is the most common site of distant metastasis in patients with EAC ACC. Further studies should determine the optimal treatment protocol for this rare malignancy.
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Affiliation(s)
- Shih-Lung Chen
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Valerie Wai-Yee Ho
- Division of Head and Neck, Plastic and Reconstructive Surgery, Department of Surgery, Queen Mary Hospital, Hong Kong, China
| | - Wen-Yu Chuang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Anatomic Pathology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kai-Chieh Chan
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Wu Q, Sun W, Bu J, Xiang Y, Zhong Y. Primary Adenoid Cystic Carcinoma of the Upper Anterior Mediastinum Mimicking a Thyroid Tumor: A Case Report and Review of Literature. Front Endocrinol (Lausanne) 2020; 11:242. [PMID: 32390945 PMCID: PMC7191109 DOI: 10.3389/fendo.2020.00242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/02/2020] [Indexed: 12/27/2022] Open
Abstract
Primary adenoid cystic carcinoma (ACC) of the upper anterior mediastinum mimicking a thyroid tumor has rarely been seen in clinical practice and lacks a standard of care therapy. Here, we report a 47-year old female patient with an ACC originated from the upper anterior mediastinum presenting as a thyroid gland tumor. The patient received gross surgical resection of the tumor and underwent post-surgical chemotherapy and radiotherapy. The patient was free from local recurrence 3-years following initial treatment, but developed multiple lung metastases. She remains under clinical observation without discomfort and is still followed as an outpatient. Here, we also summarized recent reports of similar cases with hope to provide some experience for future clinical practice.
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Affiliation(s)
- Qiuji Wu
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Weizi Sun
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiajun Bu
- Department of Oncology, Wuhan Fourth Hospital, Wuhan, China
| | - Yuanhang Xiang
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yahua Zhong
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Yahua Zhong
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Abstract
INTRODUCTION Laryngeal adenoid cystic carcinoma (LACC) is an extremely rare malignant neoplasm. The etiology of LACC remains unknown, and it is characterized by multiple recurrences, slow progression, and late distant metastasis. This study aimed to provide more information regarding the characteristics, diagnosis, and treatment of LACC by analyzing 3 clinical cases and reviewing the literature on this topic. PATIENT CONCERNS Here, we present all 3 cases of LACC within the period between 2010 and 2019. Dyspnea was the most commonly observed symptom in these patients, followed by hoarseness, pharyngeal paresthesia, and difficulty swallowing. DIAGNOSIS All patients were pathologically confirmed as LACC. INTERVENTIONS All the patients underwent a combined therapy of surgical resection plus external irradiation. OUTCOMES The follow-up time was between 2 and 6 years; no local recurrence occurred in any of the 3 patients. Lung metastasis was found in 1 patient 6 years after surgery. CONCLUSION LACC is usually a slowly progressing cancer; the main treatment methods are surgery and radiotherapy, and the adequate radiotherapy dose should usually be greater than 60 Gy. The 5-year disease-specific survival rate is high; however, distant metastasis may still occur in patients with LACC even beyond 5 years after treatment. Therefore, patients with LACC require long-term surveillance.
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Affiliation(s)
- Yu Cui
- Department of Otolaryngology
| | | | - Le Sun
- Department of Otolaryngology
| | | | - Zhanpeng Zhu
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, P.R. China
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Mendes MA, Barroso A, Campainha S. EGFR-Variant Adenoid Cystic Carcinoma of the Lung. J Thorac Oncol 2019; 13:e178-e181. [PMID: 30166019 DOI: 10.1016/j.jtho.2018.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Maria Aurora Mendes
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal.
| | - Ana Barroso
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Sérgio Campainha
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
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45
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Afzal Z, Kallumadanda S, Sotelo O. Painful, slow-growing recurrent nodules. J Fam Pract 2019; 68:E7-E9. [PMID: 31226182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The patient's mother and son had similar lesions. Histopathology revealed an uncommon diagnosis.
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Affiliation(s)
- Zeeshan Afzal
- McAllen Family Medicine Residency Program, University of Texas Rio Grande Valley, USA.
| | - Sunand Kallumadanda
- McAllen Family Medicine Residency Program, University of Texas Rio Grande Valley, USA
| | - Oscar Sotelo
- University of Texas Health Science Center, San Antonio, USA
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Thierauf J, Ramamurthy N, Jo VY, Robinson H, Frazier RP, Gonzalez J, Pacula M, Dominguez Meneses E, Nose V, Nardi V, Dias-Santagata D, Le LP, Lin DT, Faquin WC, Wirth LJ, Hess J, Iafrate AJ, Lennerz JK. Clinically Integrated Molecular Diagnostics in Adenoid Cystic Carcinoma. Oncologist 2019; 24:1356-1367. [PMID: 30926674 PMCID: PMC6795155 DOI: 10.1634/theoncologist.2018-0515] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/27/2019] [Indexed: 01/29/2023] Open
Abstract
Adenoid cystic carcinoma is a rare but aggressive type of salivary gland malignancy. This article addresses the need for more effective, biomarker‐informed therapies in rare cancers, focusing on clinical utility and financial sustainability of integrated next‐generation sequencing in routine practice. Background. Adenoid cystic carcinoma (ACC) is an aggressive salivary gland malignancy without effective systemic therapies. Delineation of molecular profiles in ACC has led to an increased number of biomarker‐stratified clinical trials; however, the clinical utility and U.S.‐centric financial sustainability of integrated next‐generation sequencing (NGS) in routine practice has, to our knowledge, not been assessed. Materials and Methods. In our practice, NGS genotyping was implemented at the discretion of the primary clinician. We combined NGS‐based mutation and fusion detection, with MYB break‐apart fluorescent in situ hybridization (FISH) and MYB immunohistochemistry. Utility was defined as the fraction of patients with tumors harboring alterations that are potentially amenable to targeted therapies. Financial sustainability was assessed using the fraction of global reimbursement. Results. Among 181 consecutive ACC cases (2011–2018), prospective genotyping was performed in 11% (n = 20/181; n = 8 nonresectable). Testing identified 5/20 (25%) NOTCH1 aberrations, 6/20 (30%) MYB‐NFIB fusions (all confirmed by FISH), and 2/20 (10%) MYBL1‐NFIB fusions. Overall, these three alterations (MYB/MYBL1/NOTCH1) made up 65% of patients, and this subset had a more aggressive course with significantly shorter progression‐free survival. In 75% (n = 6/8) of nonresectable patients, we detected potentially actionable alterations. Financial analysis of the global charges, including NGS codes, indicated 63% reimbursement, which is in line with national (U.S.‐based) and international levels of reimbursement. Conclusion. Prospective routine clinical genotyping in ACC can identify clinically relevant subsets of patients and is approaching financial sustainability. Demonstrating clinical utility and financial sustainability in an orphan disease (ACC) requires a multiyear and multidimensional program. Implications for Practice. Delineation of molecular profiles in adenoid cystic carcinoma (ACC) has been accomplished in the research setting; however, the ability to identify relevant patient subsets in clinical practice has not been assessed. This work presents an approach to perform integrated molecular genotyping of patients with ACC with nonresectable, recurrent, or systemic disease. It was determined that 75% of nonresectable patients harbor potentially actionable alterations and that 63% of charges are reimbursed. This report outlines that orphan diseases such as ACC require a multiyear, multidimensional program to demonstrate utility in clinical practice.
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Affiliation(s)
- Julia Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Nisha Ramamurthy
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Hayley Robinson
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Ryan P Frazier
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan Gonzalez
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Maciej Pacula
- Department of Pathology, Computational Pathology, Boston, Massachusetts, USA
| | | | - Vania Nose
- Department of Pathology, Head and Neck Pathology, Boston, Massachusetts, USA
- Department of Pathology, Surgical Pathology, Boston, Massachusetts, USA
| | - Valentina Nardi
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Dora Dias-Santagata
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Long P Le
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Computational Pathology, Boston, Massachusetts, USA
| | - Derrick T Lin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - William C Faquin
- Department of Pathology, Surgical Pathology, Boston, Massachusetts, USA
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Lori J Wirth
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Jochen Hess
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A John Iafrate
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Jochen K Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
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Abstract
Adenoid cystic carcinoma (ACC) is an uncommon tumor primarily occurring in the salivary glands and is relatively rare in other sites. In the liver, only one primary adenoid cystic carcinoma has been reported in the English literature. Here we presented a primary hepatic adenoid cystic carcinoma in a 44 years old male. We described its histopathologic features and its immunohistochemical profile, and reviewed the literature. The surgical treatment and patient follow up information was also presented.
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Affiliation(s)
- Jianbo Zhang
- Department of Pathology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Provincial Cancer Hospital, Zhengzhou, Henan Province, China.
| | - Yuanyuan Wang
- Department of Pathology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Provincial Cancer Hospital, Zhengzhou, Henan Province, China
| | - Dengfeng Cao
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA
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Abstract
RATIONALE Squamous carcinoma is the most common malignancy of vagina. Adenoid cystic carcinoma (ACC) in the vagina is very rare. PATIENT CONCERNS In the present study, we present a 45-year-old woman with a palpable swelling in the vagina. The patient reported body paresthesia, chest congestion, expiratory dyspnea, and itching in the thigh root. DIAGNOSIS The ultrasound results revealed inhomogeneous echoes of the muscular layer in the middle and distal of the vagina, and probed a slightly richer blood flow signal. Then biopsy was performed. On microscopic examination, it was observed that tumor cells were arranged in a tubular or cribriform pattern, and exhibited a consistent size, small nuclei, and nuclear fission. The myoepithelium was lined around the glandular cavity, but the myoepithelium was tumorous. Immunohistochemistry was performed for further verification. Vimentin was positive in mesenchyme and CK-P was positive in epithelial cells. P63 and calponin were spotted, which were focal positive around the glandular cavity. Finally, the patient was diagnosed as ACC. INTERVENTIONS At last, the patient chose chemoradiotherapy, not surgical excision. OUTCOMES The patient is alive and well 13 months after the initial diagnosis. LESSONS ACC in the vagina is extremely rare. To our knowledge, this report is the first case of ACC arising from the vagina in English-language literature. Extensive surgical section of the tumour and chemoradiotherapy are recommended for therapy. Because of rarity, the prognosis of ACC in vagina is not known.
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Affiliation(s)
- Lan-Zhi Zhang
- Department of Pathology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Li-Yan Huang
- Department of Pathology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - An-Liang Huang
- Department of Pathology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Jin-Xing Liu
- Department of Pathology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Fan Yang
- Department of Pathology, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
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Wu S, Liu J, Quan R, Han L. A rare case of nasopharyngeal adenoid cystic carcinoma treated with cetuximab-based induction therapy followed by concurrent chemoradiotherapy. Oral Oncol 2018; 89:161-163. [PMID: 30594461 DOI: 10.1016/j.oraloncology.2018.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 12/16/2018] [Accepted: 12/19/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Shihai Wu
- Department of Radiation Oncology, Second Clinical Medicine College of Jinan University, Shenzhen People's Hospital, China.
| | - Jingwen Liu
- Department of Radiation Oncology, Second Clinical Medicine College of Jinan University, Shenzhen People's Hospital, China
| | - Rencui Quan
- Department of Radiation Oncology, Second Clinical Medicine College of Jinan University, Shenzhen People's Hospital, China
| | - Ling Han
- Department of E.N.T, Second Clinical Medicine College of Jinan University, Shenzhen People's Hospital, China
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Uro-Coste E. [ENT benign lesions and pseudo-tumors: Case No. 6]. Ann Pathol 2018; 38:288-292. [PMID: 30224268 DOI: 10.1016/j.annpat.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/20/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Emmanuelle Uro-Coste
- Institut universitaire du cancer-oncopole, CHU de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
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