Adenoid cystic carcinoma of jugular foramen

Adenoid cystic carcinoma is a slowly growing malignant tumor with high local recurrence, perineural and vascular invasion. This tumor might arise from the glands of upper respiratory tract and oral cavity (eg, salivary or serous or mucous). Here we report the case of a 65-year-old woman who was referred to our unit for left retro-auricular radiating pain with trigger points and frontal headache since 6 months. There was no involvement of cranial nerves. Imaging screening using MRI, Positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-D-glucose, Gallium-68 DOTA-Phe1-Tyr3-Octreotide (68Ga DOTATOC) Positron emission tomography-CT suggested a suspicion of schwannoma or paraganglioma of the jugular foramen. However, the CT-guided biopsy revealed presence of adenoid cystic carcinoma. These warrants performing mandatory histological analysis combined with imaging screening suspicion of schwannoma or paraganglioma.     

Unusual presentation of parotid gland adenoid cystic carcinoma : A case presentation and literature review

Adenoid cystic carcinoma (ACC) represents approximately 10% of all epithelial salivary neoplasms and most commonly involves the parotid gland.We report CT and MRI finding of a 38-year-old young man presented to our ENT department with 02 years history of an external auditory canal stenosis. Physical examination revealed bilateral parotid gland swelling with a complete stenosis of the left external auditory canal.Temporal bone contrast enhanced CT-SCAN revealed is an isodense enhancing mass measuring 4 cm involving posterior and inferior external auditory canal wall, and invading the superficial lobe of the homolateral parotid gland. No bone erosion was noted. MRI investigation has shown a tumor process highly suspicious of malignancy centered on the left EAC involving the superficial lobe of the homolateral parotid gland. Adenoid cystic carcinoma (ACC) of the parotid gland was the final diagnosis, after surgical biopsy and histopathological examination. The Pre-operative check-up demonstrated multiple round shape lung lesions suggestive of multiple metastases. Considering the metastatic stage of the tumor, a collegial decision to adopt a palliative treatment approach based on chemotherapy was taken by the multidisciplinary oncology board.     

Intracranial adenoid cystic carcinoma mimicking meningioma: report of two cases

Two cases of intracranial adenoid cystic carcinoma mimicking meningioma are reported. In one, MRI showed not only a homogeneously enhancing extra-axial tumour attached to the dura mater of the posterior cranial fossa, but also surrounding dural enhancement, the dural tail sign. In the second, CT demonstrated a well-demarcated enhancing extra-axial tumour, indistinguishable from a sphenoid ridge meningioma extending into the orbit. The neuroradiological features of intracranial adenoid cystic carcinoma may thus closely resemble those of meningioma.     

气管腺样囊性癌的MSCT表现

目的:探讨气管腺样囊性癌的MSCT表现特征。方法:回顾性分析经手术病理证实的5例原发性气管腺样囊性癌的MSCT表现。所有患者术前均行胸部MSCT平扫和增强扫描。结果:5例均主要表现为腔内宽基底的软组织密度肿块,其中3例伴腔外累及。5例中发生于胸段气管3例,右主支气管2例,其中1例累及气管隆突和左主支气管开口。肿瘤形态均不规则,多平面重组冠状位显示肿瘤沿管壁生长,长径大于横径,最大长径1.8~5.5cm,平均3.4cm,伴管壁增厚,管腔不同程度狭窄。肿瘤平扫密度尚均匀,瘤内未见钙化,增强后不均匀强化。1例伴有右肺门和纵隔肿大淋巴结。所有患者均未见胸腔积液。结论:气管腺样囊性癌的MSCT表现具有一定的特征。结合多平面重组技术,MSCT能够准确反映ACC的生长方式及腔内外生长、管壁浸润增厚等特性。     

气管腺样囊性癌的CT表现（附5例报告及文献复习）

目的探讨CT对气管腺样囊性癌的诊断价值。方法回顾性分析5例经手术和病理证实的气管支气管腺样囊性癌的CT表现,并复习国内外相关文献。结果气管腺样囊性癌在CT上兼有良恶性肿瘤的特征,CT轴位扫捕及其后处理技术的应用能准确地描述气管支气管腺样囊性癌的病变范围及气管腔内外的改变。结论CT对气管腺样囊性癌具有重要的诊断价值,应作为首选检查方法。     

Long-term local control of recurrent adenoid cystic carcinoma in the parotid gland with radiotherapy and intraarterial infusion chemotherapy

We report a case of postoperative recurrence of adenoid cystic carcinoma in the left parotid gland treated with radiotherapy and arterial infusion chemotherapy. A 52-year-old woman had a history of surgical resection for an adenoid cystic carcinoma arising from the left parotid gland 25 years before. Despite two reoperations for local recurrence after the initial surgery, she had a third local recurrence in the remnant of the left parotid gland. The patient was treated with a concurrent combination of radiotherapy (60 Gy/30F) and intraarterial infusion chemotherapy with carboplatin (750 mg/30 days) from which she obtained a complete response. The patient has remained free of local progression 54 months after treatment. Radiotherapy and arterial infusion chemotherapy is effective treatment for local recurrence of adenoid cystic carcinoma in the head and neck.     

A rare case of metastatic small cell carcinoma of breast from mixed types of cervical carcinoma

Metastatic small cell carcinoma to the breast from the uterine cervix is an extremely rare case. We report a case of a 58-year-old postmenopausal woman who presented with postmenopausal bleeding. Further investigations confirmed the diagnosis of mixed types of squamous and small cell cervical carcinoma. She underwent chemoradiotherapy and brachytherapy. A few months later, she presented with a palpable left breast lump three months after the diagnosis. Diagnosis of metastatic small cell carcinoma of the breast was confirmed by biopsy. Due to its rarity, we report on this case along with its relevant literature review.     

Radiological features of adenoid cystic carcinoma of the uterine cervix

Adenoid cystic carcinoma (ACC) of the uterine cervix is a rare primary neoplasm of the uterus that occurs in post-menopausal women; its radiological findings have not been described previously. We present the MR findings of a case of ACC. The mass exhibited homogeneous low-signal intensity on T1-weighted images. On T2-weighted images, the mass showed high-signal intensity with a lobulated contour and multiple septum-like internal architectures. It also contained spots of very high-signal intensity, which would represent the mucin in the glandular lumen. The multiple septum-like internal architectures probably represented interglandular fibrous stroma. These MRI findings may be helpful for future diagnoses of ACC of the uterine cervix.     

Surgery combined with iodine-125 interstitial brachytherapy for treatment of parotid adenoid cystic carcinoma: A single-institution experience

PurposeThe purpose of this study was to analyze the effectiveness and safety of the combination of surgery plus postoperative iodine-125 interstitial brachytherapy for treatment of adenoid cystic carcinoma (ACC) of the parotid.Methods and MaterialsThis study included a retrospective analysis of the data of patients who underwent postoperative iodine-125 interstitial brachytherapy for histology-confirmed ACC of the parotid between January 2002 and November 2018 in Peking University Hospital of Stomatology. Acute and long-term radiation-related toxicities were assessed by the criteria of the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer. Multivariate analysis was used to identify the factors affecting overall survival, disease-free survival (DFS), and distant metastasis–free survival (DMFS).ResultsA total of 86 patients (53 women; median age 50 years, SD = 13.1) were included. Median followup was for 45.5 months. About half the patients (44/86, 51.3%) had clinical stage IV disease. Local recurrence occurred in 11 of 86 (12.8%) patients. No patient had nodal metastases in the followup period. The five- and 10-year DFS rates were 74.8% and 66.6%, respectively. The mean DMFS was 60.6 months. On multivariate analysis, preoperative facial palsy, type of surgery, perineural spread (PNS), and distant metastases were independent prognostic factors for DFS; preoperative facial palsy, nodal metastases, and PNS were independent prognostic factors for overall survival; and preoperative facial palsy, type of surgery, PNS, and pathological type were independent prognostic factor for DMFS.ConclusionsThe combination of surgery and iodine-125 interstitial brachytherapy appears to be an effective and safe treatment for primary ACC of the parotid.     

Adenoid cystic carcinoma of the breast. A case report and review.

Adenoid cystic carcinoma of the breast is a malignant tumour of significant incidence with a better prognosis than histologically identical tumours occurring in other sites and as compared to other malignant tumours of the breast. The recognition of the tumour is important especially in the management of the individual patient but also in furthering understanding of growth, spread and biological behaviour of tumours.     

泪腺腺样囊性癌的CT和MRI诊断

目的研究泪腺腺样囊性癌的CT和MRI表现。资料与方法回顾性分析32例经组织学证实的泪腺腺样囊性癌患者的影像学资料。结果32例均为单侧发病,其中位于左侧19例,右侧13例。CT表现：病变呈长圆形11例,不规则形8例,扁平形7例,卵圆形4例,分叶状2例;24例边界清楚,10例轮廓呈锯齿状;11例密度不均匀,内见低密度区和／或钙化,增强后中到高度强化;24例包绕并压迫眼球,16例沿眶外壁向眶尖区生长,与外直肌分界不清,其中4例浸润视神经;邻近眶壁骨质虫蚀样破坏24例,明显溶骨性破坏3例。MRI表现：与正常眼外肌比较,T1WI呈低信号14例,等信号12例,T2WI呈高信号22例,等信号4例,其中22例信号不均匀,中到高度强化。病变可蔓延到颅内、颞窝、颞下窝、翼腭窝等邻近结构,也可沿神经周扩散。结论泪腺腺样囊性癌有特异影像学征象,可提示诊断;CT是诊断本病的主要影像检查方法,MRI能更清楚地显示病变的范围,CT联合MRI可对诊断、治疗提供重要信息。     

强力霉素对恶性肿瘤细胞金属蛋白酶表达和分泌的调节及其意义

目的 :揭示金属蛋白酶表达和分泌与恶性肿瘤侵袭转移的关系 ,并探索强力霉素应用于恶性肿瘤侵袭转移治疗的可能。方法 :用免疫组织化学方法和明胶电泳酶谱法研究强力霉素作用后PC - 3细胞和SAcc83细胞中MMP - 2表达和分泌的变化及其侵袭转移能力的变化。结果 :经强力霉素处理后的PC - 3细胞和SAcc83细胞MMP - 2的表达和分泌明显减少 ,侵袭能力下降 (P <0 .0 1)。结论 :MMP - 2的表达和分泌与恶性肿瘤的侵袭与转移能力有关。强力霉素有可能应用于恶性肿瘤侵袭转移的治疗。     

气管腺样囊性癌1例

患者男,44岁。主诉：咳嗽、咯痰、呼吸困难3月余。患者自述3月前无明显诱因出现咳嗽、咯痰甚至呼吸困难,无发热、咯血、气喘、胸闷、胸痛、心悸、咽部异物感,亦无明显体重下降。食欲可、夜休可、大小便正常。     

食管腺样囊性癌(附4例报告)

目的：提高对食管腺样囊性癌的认识和诊断。方法：回顾分析４例（男３例女１例,年龄４２～４６岁）经手术和病理证实的食管腺样囊性癌的Ｘ线表现。结果：（１）圆形或椭圆形腔内隆起,表面光滑;（２）向腔内突出的蕈伞样或息肉样肿物,分叶状,表面不光滑;（３）食管粘膜紊乱、破坏、龛影,管腔轻度狭窄;（４）管壁局限或环形僵硬,管腔狭窄,粘膜尚光滑,呈梗阻状。结论：上述Ｘ线表现对诊断食管腺样囊性癌有重要价值     

18F-FDGPET／CT在腺样囊性癌术后中的应用价值

目的：探讨18F-FDGPET/CT在腺样囊性癌术后中的应用价值。方法回顾性分析2007年8月-2014年3月13例腺样囊性癌术后18F-FDGPET/CT检查图像资料,分析其特点,以提高对该病局部复发或远处转移的认识,所有病例确诊肿瘤复发、转移的依据为再次手术或穿刺病理及临床随访证实。结果13例腺样囊腺癌中,其中位于右颌下腺3例,左颌下腺2例,而位于左上唇、左侧鼻腔、右侧鼻腔、右侧蝶窦及筛窦、右上颌窦、气管下段、口底、右侧硬颚各1例。经手术病理或随访证实,局部复发2例,未见局部复发11例,PET/CT诊断复发5例,未见局部复发8例,PET/CT对术区局部复发诊断敏感性为100％,特异性为78．6％;远处转移9例,PET诊断转移7例,转移性病变诊断敏感性为77.8％,特异性为100％,其中4例改变了临床分期。其中颈部淋巴结转移3例,双肺转移4例,肝脏及骨骼多发转移1例,双肺、骨骼转移1例,同时并双肺、肝脏、骨骼多发转移1例。肿瘤局部复发病例中,SUVmax最大值为15．3,SUVmax最小值为7．4;转移性病变中,其中SUVmax最大值为15．8,SUVmax最小值为0．8。结论腺样囊性癌是一种高度侵袭性恶性肿瘤,具有生长速度慢、手术治疗后易局部复发和长期随访易发生远处转移等特点。因此,18F-FDGPET/CT一次显影全身显像,不仅对腺样囊性癌术后局部有无复发有重要诊断价值,而且对远处转移也有很好的参考意义。     

头颈部腺样囊性癌的CT、MRI诊断

目的 探讨CT、MR1对头颈部腺样囊性癌的诊断价值.方法 回顾性分析20例经病理证实的头颈部腺样囊性癌的临床及CT、MRI资料.结果 病变发生于上腭者5例,口底4例,腮腺4例,鼻腔及上颌窦3例,颌下腺2例,泪腺及面颊部各1例.CT表现为类圆形或不规则形的软组织肿块,增强后不均匀强化,侵犯邻近骨质3例.MRI平扫病灶呈等或稍长T1信号,长T2信号,增强后病灶明显不均匀强化,2例可见神经侵犯征象.结论 CT对肿瘤周围骨质破坏情况显示较好,MR1能够更清晰显示病变形态、轮廓及侵犯范围.两者结合可为该病的诊断和治疗提供更全面的影像信息.     

Comparison of outcomes using radiotherapy or brachytherapy after resection of primary adenoid cystic carcinoma in oral and maxillofacial regions

We wished to investigate the outcome of surgery combined with external-beam radiotherapy (EBRT) or brachytherapy (¹²⁵I seeds) for the treatment of primary adenoid cystic carcinoma (ACC) of the oral and maxillofacial region. Data of patients with primary ACC were reviewed retrospectively. Patients were divided into EBRT and brachytherapy groups. Wide tumor excision was done to achieve negative margins. Standard radiotherapy in the EBRT group was 60 Gy. A treatment-planning system was used to create implantation plans with a prescribed dose of 60–120 Gy and ¹²⁵I seeds were implanted postoperatively. Kaplan–Meier method and log-rank tests were used to analyze local control and survival. The median duration of followup was 66.1 and 46.8 months for the EBRT group and brachytherapy group, respectively. There was no significant difference in local control, control of metastasis to regional lymph nodes, or control of distant metastasis between the two groups. There was no significant difference in overall survival, disease-specific survival, or disease-free survival in the two groups at 3 years and 5 years. The prevalence of complications in the brachytherapy group was lower than that in the EBRT group. Both methods elicited good treatment effects, but the prevalence of adverse events was lower in the brachytherapy group.