Adenoid cystic carcinoma of the nasopharynx after previous adenoid irradiation

In 1978, Pratt challenged the otolaryngology community to identify an incidence of malignancy in individuals who have previously received radium therapy to the nasopharyngeal lymphoid tissues. This case report is a direct response to that quest and presents a well documented adenoid cystic carcinoma evolving 23 years after radium applicator treatment to the fossa of Rosenmuller. Although a cause-and-effect relationship cannot be scientifically proven, the case history raises several important questions concerning the stimulating effects of radiation on the later onset of frank malignancy.     

鼻咽部腺样囊性癌的治疗体会

目的总结鼻咽腺样囊性癌的临床特征、治疗方法及预后，探讨更有效的治疗方式。方法回顾性分析中国医学科学院肿瘤医院头颈外科1968年1月—2000年5月问21例原发于鼻咽的腺样囊性癌患者的临床资料，分析单纯放疗与放疗结合手术两种治疗方式的5、10年的无瘤生存率以及肿瘤复发情况。结果21例鼻咽腺样囊性癌患者就诊时的主要症状有回吸性涕中带血、头痛、鼻塞、耳聋耳闷、复视伴视力减退及面部麻木等。其中T1、他期患者占28．6％（6／21），T3、T4期患者占71．4％（15／21）。颈部淋巴转移率为14．3％（3／21）。13例行单纯放疗，8例放疗结合手术治疗。2l例鼻咽腺样囊性癌患者失访1例，5年无瘤生存率为42．9％（9／21）。单纯放疗的5年无瘤生存率为38．5％（5／13），放疗结合手术的5年无瘤生存率为50．0％（4／8），二者差异无统计学意义（P=0．472）。随访10年的无瘤生存率为16．7％（3／18）。单纯放疗的10年无瘤生存率为0／12，放疗结合手术的10年无瘤生存率为50．0％（3／6），二者差异有统计学意义（P=0．025）。治疗后的局部复发率为50．0％（10／20）。单纯放疗的局部复发率为66．7％（8／12），放疗结合手术的局部复发率为25．0％（2／8），二者差异无统计学意义（P=0．085）。远处转移率为30．0％（6／20）。单纯放疗的远处转移率为25．0％（3／12），放疗结合手术的远处转移率为37．5％（3／8），二者差异无统计学意义（P=0．455）。结论鼻咽腺样囊性癌治疗后局部复发率高，晚期易出现远处转移。与单纯放疗相比，放疗结合手术可以提高鼻咽腺样囊性癌的10年无瘤生存率。     

Adenoid cystic carcinoma of the supraglottic larynx: report of a case and review of the literature

Although adenoid cystic carcinoma is the most common malignant tumor of the minor salivary glands, it seldom occurs in the larynx. Less than 0.25 per cent of all laryngeal carcinomas are adenoid cystic, and only 15 such cases of supraglottic origin are recorded in the literature. In only four cases the details of treatment and outcome are described. We report another case and review the literature in order to define the entity of adenoid cystic carcinoma of the supraglottic larynx. This case reveals the aggressive nature of the disease, which is often associated with the solid variant histology and also demonstrates the most rapid course of any cases described in the literature. Other histologic variants of adenoid cystic carcinoma of the supraglottic larynx follow a more prolonged course that can extend many years even with persistent local disease. However, development of distant metastases may eventually occur. Therefore, 5-year statistics are not adequate, and 10 or 20 years' follow-up is required to evaluate the curability of this disorder. Evaluation, treatment, and clinical course of adenoid cystic carcinoma of the supraglottic larynx are discussed.     

Collision tumor of a hypopharyngeal adenoidcystic carcinoma and a laryngeal squamous cell carcinoma

INTRODUCTION: Malignancies in head and neck cancer are mainly squamous cell carcinomas. Adenoid cystic carcinomas are rare lesions of this site. Laryngeal adenoid cystic carcinoma is estimated to occur in 0.1 - 0.7 % of all laryngeal carcinomas. Adenoid cystic carcinomas are rarely located in the hypopharynx. To our knowledge there is no case report of adenoid cystic carcinoma of the hypopharynx as part of a collision tumor of the larynx. CASE REPORT: A 47-year-old male patient was diagnosed with an adenoid cystic carcinoma of the hypopharynx and a squamous cell carcinoma of the larynx. Because of local extension of both tumors laryngectomy and partial pharyngotomy with bilateral neck dissection was performed followed by radiation therapy. Clinical aspects as well as histomorphological and immunohistochemical criteria of both tumor entities are discussed. DISCUSSION AND CONCLUSIONS: Immunohistochemical characteristics showed two different carcinoma entities in the larynx and hypopharynx. Only by complete histological investigation of a carcinoma those rare cases of a collision tumor can be detected. Both tumor entities need to be considered for therapy strategy and oncological follow-up planning.     

A case report of adenoid cystic carcinoma of the nasal septum]

A 50-year-old woman with adenoid cystic carcinoma of the nasal septum is presented. Her chief complaint was recurrent epistaxis. Surgery was originally performed to remove a nasal polyp, but during resection, the surgeon discovered that the mass had arisen from the nasal septum, so only a biopsy was done. The pathological report was adenoid cystic carcinoma, so she was referred and admitted to our hospital. A flat 1.5 x 1.5 cm tumor was recognized on the left side of the nasal septum. Nasal septectomy was performed. The tumor was dissected with nasal septal cartilage, and the defect was covered with a free skin flap from the thigh. The incidence of malignant tumors from the nasal septum is very low, composing from 2.7% to 8.4% of nasal and paranasal malignant tumors. Therefore the incidence of adenoid cystic carcinoma in particular is very low.     

Ceruminous gland tumour (a case report)

A case of adenoid cystic carcinoma of a ceruminous gland in the external auditory meatus, treated by local excision, is presented.     

Mandibular ameloblastoma and maxillary adenoid cystic carcinoma: case report

We report the case of a 74-year-old woman who developed a follicular ameloblastoma of the right mandible and 22 months later developed a cribriform adenoid cystic carcinoma of the soft palate on the right maxilla. The ameloblastoma was treated by hemimandibulectomy, and the adenoid cystic carcinoma was managed by resection of the soft palate and the surrounding tissue and bone followed by a 6-week course of radiotherapy. Our review of the literature indicates that only one similar case has been previously reported where an odontogenic tumor and a salivary gland tumor involved two different anatomic locations in the same patient at nearly the same time.     

Basal cell adenoma of the parotid. An ultrastructural study

The monomorphic basal cell adenoma of parotid gland is a rare tumor of salivary glands. Its diagnosis is difficult with adenoid cystic carcinoma. In the case reported here, a peculiar type named membranous adenoma, the thickness of basement membranes, their penetration inside the epithelial lobules, form true cylinders as in adenoid cystic carcinoma. The histoenzymology and the electron microscopy provide important diagnostic arguments: activity of alkaline phosphatases lower than in cystic adenoid carcinoma; cells of adenoma more differentiated (epidermoid or secretory cells) than those of cystic adenoid carcinoma. The prognosis of the tumor is good, though recurrences may occur.     

Sinonasal adenoid cystic carcinoma seeding to the tracheostomy site

Neoplastic seeding of head and neck carcinomas is a well-documented but relatively rare occurrence. We report a rare case of seeding of a sinonasal adenoid cystic carcinoma to a tracheostomy site.     

Sinonasal adenoid cystic carcinoma with widespread symptomatic bony metastasis

Adenoid cystic carcinoma is a fairly uncommon salivary neoplasm of the head and neck. These lesions often progress insidiously, and they have a propensity for early perineural spread and bony invasion. Distant metastasis to the lungs is fairly common and is usually fatal. We report a rare case of adenoid cystic carcinoma in a patient who on initial evaluation had widespread bony metastasis but no pulmonary involvement.     

Adenoid cystic carcinoma of the nasal septum

Adenoid cystic carcinoma is a malignant tumour frequently described arising from seromucinous salivary tissue in the major and minor salivary glands. Within the nasal cavity, it is uncommon and usually involves the lateral wall. A rare case of adenoid cystic carcinoma of the nasal septum is presented along with a review of the literature. The presentation and management of this uncommon condition is discussed.     

Bilateral basal-cell adenomas in the parotid glands

A rare case of bilateral basal-cell adenomas in the parotid glands of a 65-year-old woman is reported. There have been only four previous reported cases of bilateral parotid basal-cell adenomas, all of which occurred synchronously with dermal cylindromas. The present lesion is the first case reported in the English literature of bilateral parotid basal-cell adenoma without coexisting dermal cylindroma. Histological examination revealed that the left tumour had adenoid cystic change, which closely resembled adenoid cystic carcinoma. This case is of interest not only because of the raity of bilateral parotid basal-cell adenomas, but also because of the necessity for differentiation from adenoid cystic carcinoma in order to plan appropriate treatment.     

Adenoid cystic carcinoma of the submaxillary gland

A review of submaxillary gland neoplasms over a 21 year period revealed 15 malignancies and 7 benign tumors. All of the malignancies occurred in females, and 11 of these were adenoid cystic carcinoma. Two of the 11 were found to have infiltrating ductal carcinoma of the breast (1 pre and 1 postdiagnosis of the submaxillary carcinoma) and 3 had benign breast disease. While previous reports have suggested an association of parotid gland neoplasia and breast cancer, this is the first known report of an association between adenoid cystic carcinoma of the submaxillary gland and cancer of the breast. The discussion of adenoid cystic carcinoma of the submaxillary gland emphasizes the increased frequency of this disease in females, its association with breast disease, and also experimental submaxillary gland neoplasia.     

Hybrid tumours of the salivary glands. A report of two cases involving the palate and a review of the literature

Hybrid tumours are very rare salivary gland lesions composed of two or more different tumoural entities in a single neoplasm that arise within a definite topographical region. In most cases adenoid cystic carcinoma has been the predominant component in these lesions. In this study we describe two patients with hybrid tumours located in the palate, one in a 49-year-old woman and one in a 71-year-old man. The first case involved adenoid cystic carcinoma and mucoepidermoid carcinoma, and the patient in the second case exhibited adenoid cystic carcinoma and epithelial-myoepithelial carcinoma. Both patients were treated with surgery and radiotherapy, and there has been no evidence of recurrence after 13 and 36 months of follow-up, respectively. The recognition of the histologic component with the higher grade of malignancy in every case of hybrid tumour of the salivary glands is a necessary step to determine the biological behaviour and, consequently, to determine the proper therapeutic approach.     

内镜下切除鼻咽部肿瘤入路及体会

目的 介绍内镜下经鼻中隔切除鼻咽部肿瘤的方法,探讨此手术方法的优缺点、适应范围和手术注意事项.方法 10例鼻咽部肿瘤患者分别为鼻咽癌放疗后残留3例、海绵状血管瘤2例、良性混合瘤2例、恶性混合瘤1例、腺样囊性癌1例和脊索瘤1例.所有病例均行内镜下鼻中隔后下段1/4切除,手术者和助手经双侧鼻腔径路协作完成肿瘤切除.结果 所有病例的鼻咽肿瘤均一次性全切,无严重手术并发症和后遗症.4例良性肿瘤随访6～18个月无复发,中位随访时间13.8个月;6例恶性肿瘤随访1～4年,中位随访时间2.6年,5例无瘤生存,1例鼻咽癌患者术后1年疑似复发,进一步观察6个月病变无进展.结论 鼻中隔后下段1/4切除后,内镜下能观察整个鼻咽腔及其中的肿瘤,并有利于手术者和助手协调配合完成手术,是一种切除鼻咽部局限性肿瘤较好的手术方法.

Abstract：

Objective To explre the techniques, advantages and disadvantages, indications and cautions of a surgical approach for the resection of nasopharyngeal tumor. Methods Ten cases with nasopharyngeal tumors were recruited in this study, of them, 3 cases with residual nasopharyngeal carcinoma after chemoradiotherapy, 2 cases with cavernous angioma, 2 cases with benign mixed tumor, 1 malignant mixed tumor, 1 adenoid cystic carcinoma, and 1 chordoma. All patients underwent endoscopic resection of posteroinferior quarter part of nasal septum, and then the removal of nasopharyngeal tumors through bilateral transnasal approach. Results Total resection of the tumor was achieved for all cases without severe surgical complications. All cases with benign tumors, with following-up of 6 -18 months, showed no recurrence. Of 6 cases with malignant tumors, with following-up of 12 -48 months, 5 cases showed no recurrence, and 1 case was suspected to relapse one year postoperatively, but not with any lesion enlargement after another 6 month follow-up. Conclusions Posteroinferior quarter part of nasal septectomy is preferred for endoscopic resection of nasopharyngeal tumors because it can provide a panoramic view on nasopharyngeal cavity and tumors, thus, facilitating the removal of nasopharyngeal tumors.     

The adenoid cystic carcinoma

The adenoid cystic carcinoma arising in the external auditory canal is a rare tumor, as other malignant neoplasias of the EAC and middle ear. The early diagnosis of these malignant tumors of the ear is very important to improve the prognosis. In this sense, the clinic experience is frequently the most useful diagnosis instrument to suspect this pathology when we have a confrontation with chronic otorrea and otalgia, common presentation form of this disease. In this report we show a new case of adenoid cystic carcinoma of external auditory canal and review the most significant medical literature existing in relationship with this pathology.     

Primary mucoid adenocarcinoma of the larynx.

Mucous glands carcinomas of the larynx are rare, with most being represented by 'non-specific' adenocarcinoma and adenoid cystic carcinoma. Here we report a unique case of mucoid adenocarcinoma of the larynx occurring in a 46-year-old woman. Despite the presence of regional lymph node metastasis, she remained well four years after surgery.     

鼻腔鼻窦腺样囊性癌18例临床分析

目的：探讨鼻腔鼻窦腺样囊性癌的临床特点。方法：18例鼻腔鼻窦腺样囊性癌患者,16例行手术＋术后放疗,2例行单纯放疗。结果：随访5年,早期（Ⅰ、Ⅱ期）患者8例均无死亡;晚期（Ⅲ、Ⅳ期）患者10例,死亡5例,失访1例。高分化组11例中,1例死亡;中低分化组7例中,死亡4例,失访1例。结论：鼻腔鼻窦腺样囊性癌临床症状不典型,应提高对该病的认识,防止误诊;预后有赖于病理分型和临床分期;高分期及高侵袭性腺样囊性癌预后差。     

Adenoid cystic carcinoma of the larynx

The adenoid cystic carcinoma represents less than 1% of all the malignant tumours located in the larynx. Only about 80 cases have been described so far in world literature. In contrast with the epidermoid carcinoma of the larynx, the adenoid cystic carcinoma is not apparently related to common risk factors such as smoking. However the prognosis is much worse, with survival rates of less than 20% after 15-20 years. Treatment is surgical, although radiotherapy may be of help. In this paper a new case of adenoid cystic carcinoma located in the supraglottis of a 26-years-old woman is reported and the world literature is reviewed.     

Adenoid cystic carcinoma of tongue. Report of a case and literature review

We report the clinical case of an adenoid cystic carcinoma on the base of the tongue, a rare malignant tumor of slow-growing but aggressive with a propepnsity for perineural invasion. Treatment modalities more common include surgery and radiotherapy but locorregional recurrences are frequent and relatively early in the first years. A review of the literature of this pathology is performed.