Current thinking in the management of adenoid cystic carcinoma of the head and neck

Adenoid cystic carcinoma (ACC) is an aggressive, rare, malignant tumour that accounts for about 1% of all head and neck neoplasms and 10% of all salivary gland tumours. It is characterised by frequent local recurrences and distant metastases. Growth is slow but relentless, and progression poses a challenge to head and neck clinicians. Many small retrospective studies have described its clinical management, but the lack of multicentre, randomised, controlled trials has resulted in inconsistencies in management globally. We have focused on three key management-related controversies: the role of elective neck dissection (END) for the N0 neck; the role of adjuvant treatment or radiotherapy; and finally, the follow-up protocol, particularly cross-sectional surveillance imaging of the full body or chest computed tomography (CT) alone, and options for treatment if metastases are found. The paucity of published studies may reflect the inconsistencies that exist in the management of ACC of the head and neck in the UK. The collaboration of head and neck centres would, we think, help to correct the imbalance in these three domains of care.     

两种小阴唇肥大缩小术的临床应用比较

目的探索改良边缘切除法、楔形切除法在小阴唇肥大缩小术中的临床应用效果。方法选取2017年9月-2019年9月在郑州大学第三附属医院行小阴唇肥大缩小术的47例双侧小阴唇肥大患者,根据小阴唇肥大的程度和小阴唇形态分型以及患者需求选择改良边缘切除法22例,楔形切除法25例。比较两组患者的术中出血量、手术时间、切口愈合情况及手术满意度,采用女性性功能指数简表评分(FSFI-6量表)对患者的性生活情况进行评估。结果两组间手术时间比较显示边缘切除法手术时间较楔形切除法短(P<0.05),但两组间术中出血无明显差异(P>0.05)。两组患者术后满意度均较高。两组患者术后性生活湿润度、满意度评分及总评分较术前提高,差异有统计学意义(P<0.05)。两组患者的术前术后性欲望、性唤醒、性高潮频率方面表现无差异(P>0.05)。结论两种小阴唇肥大缩小术均可有效治疗小阴唇肥大,医生需结合患者小阴唇肥大类型和个人审美要求制定设计个性化的治疗方案。     

Morphological spectrum of adenoid-cystic carcinoma of the breast: focus on diagnostic and prognostic features

Adenoid cystic carcinoma (AdCC) is a salivary gland-type of cancer that may also occur in the breast. Breast AdCC shows the same morphological spectrum as is observed in salivary glands, with recognition of individual subtypes that may differ in their clinical behaviour. AdCC classic variant (C-AdCC) is a slowly growing tumour, with a low rate of axillary node and distant metastases. Local recurrences may develop as a consequence of incomplete surgical excision. C-AdCC should be differentiated from the solid-basaloid variant of AdCC (SB-AdCC) that is characterized by nuclear atypia, frequent mitotic figures and necrosis, in addition to the solid architecture. SB-AdCC is a more aggressive tumour, with higher rates of axillary node and distant metastases. AdCC may also co-exist with more aggressive types of carcinoma including metaplastic and neuroendocrine carcinoma, referred to as AdCC with high grade transformation (HG-AdCC). This paper reviews the key diagnostic criteria of the different subtypes of breast AdCC with emphasis on differential diagnosis and prognostic parameters.     

小阴唇整形术专家共识（2020年版）

        随着社会的发展，人们对美的追求越来越高，小阴唇整形也逐渐受到人们的关注。尽管小阴唇整形术方法有很多，但手术指征、手术方式选择、围术期管理及术后并发症防治等缺乏统一的标准［1-2］。中国整形美容协会女性生殖整复分会组织专家，根据文献报道［3］和专家经验，经过反复的讨论和修改，对小阴唇整形术提出如下共识，以期为临床医生对小阴唇肥大的诊治及整形决策提供参考及借鉴。 浏览更多请关注本刊微信公众号及当期杂志。