Resection and Reconstruction of Maxillary Class IIIc Defect in a Case of Adenoid Cystic Carcinoma: Cost-Sensitive Technique without Microvascular Grafts

ACC is a rare malignant tumor that affects most commonly the major and minor salivary glands and rarely the paranasal sinuses, lacrimal gland, larynx, ear, vulva, and so forth. The maxillary sinus when affected is considered having a poor prognosis due to delayed diagnosis and delayed treatment credited to its slow spread, late symptoms, and complex anatomy which hampers surgical resection. The expressions of tumor markers too have a significant role in determining the prognosis. The treatment of choice consists of wide radical resection of the tumor followed by radiotherapy. Rehabilitation options in cases with huge maxillary defects still need further exploration.

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Laryngeal Adenoid Cystic Carcinoma in a Child: A Case Report

Ear Nose & Throat Journal ◽

10.1177/014556130208100111 ◽

2002 ◽

Vol 81 (1) ◽

pp. 34-35 ◽

Cited By ~ 15

Author(s):

Morteza Javadi ◽

Fathollah Mousavi Bafrouee ◽

Mohammad Mohseni ◽

Alimohamad Asghari

Keyword(s):

Case Report ◽

Local Recurrence ◽

Adenoid Cystic Carcinoma ◽

Malignant Tumor ◽

Late Stage ◽

Delayed Diagnosis ◽

Minor Salivary Glands ◽

Adenoid Cystic ◽

Carcinoma Of The Larynx ◽

Systemic Metastasis

Adenoid cystic carcinoma is a malignant tumor of the major and minor salivary glands. Because it grows very slowly, it is often diagnosed at a late stage. The combination of a delayed diagnosis and the tumor's propensity for early perineural and hematologic spread increases the risk of local recurrence and systemic metastasis, often many years after the primary tumor has been diagnosed and treated. Only 80 cases of adenoid cystic carcinoma of the larynx have been previously reported in the literature. We report a new case of laryngeal subglottic adenoid cystic carcinoma in a 12-year-old boy.

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Radical Resection and Reconstruction in Patients With Adenoid Cystic Carcinoma in the Minor Salivary Glands of the Palate

10.21203/rs.3.rs-1110048/v1 ◽

2021 ◽

Author(s):

Wei-liang Chen ◽

Yan Wang ◽

Bin Zhou ◽

Juan-kun Liao ◽

Rui Chen

Keyword(s):

Adenoid Cystic Carcinoma ◽

Salivary Glands ◽

Radical Resection ◽

Stage I ◽

Stage Iii ◽

Radical Excision ◽

Titanium Mesh ◽

Minor Salivary Glands ◽

Ki 67 ◽

Adenoid Cystic

Abstract Background: This study evaluated the clinical outcomes of the patients with adenoid cystic carcinoma (ACC) of the minor salivary glands of the palate. Methods: Forty-four patients with stage I–II disease and 14 patients with stage III–IV disease underwent radical excision and reconstruction with a facial-submental artery island flap (FSAIF) and titanium mesh plus a free anterolateral thigh flap (ALTF) and radiotherapy respectively. Patients with stage III–IV disease subsequently received cobalt Co 60 adjuvant radiotherapy. Ki-67 expression was determined semiquantitatively in 52 patients with ACC by based on the cytoplasm staining intensity and percentage of positively stained tumor cells.Results: The median (range) follow-up was 32.9 (14–58) months. Forty-one (71.7%) patients survived without disease recurrence. Nine patients (15.5%) survived with recurrent tumors (four with local recurrence, three with regional recurrence requiring salvage surgery, and two with distant metastasis); among these patients, five had overlapping recurrence. Eight patients (13.8%) died of regional, distant, or multiorgan metastasis (range: 22–42 months). The overall median (95% CI) survival time was 32.5 (25.0–39.5) months, and the median (95% CI) progression-free survival time was 32.9 (28.5–36.9) months. Rates of survival and recurrence differed significantly between patients with low- and high-grade tumors, patients with clinical stage I–II disease and those with stage III–IV disease, patients with and without lymph node metastasis, patients who underwent radical excision with versus without radiotherapy, and patients with low and high Ki-67 expression. Conclusion: Radical resection and reconstruction with FSAIF is the most suitable treatment for stage I–II ACC of the minor salivary glands of the palate. Stage III–IV tumors require radical resection, reconstruction with titanium mesh and free ALTF, and radiotherapy.

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Neoadjuvant intraarterial cytoreductive chemotherapy for lacrimal gland adenoid cystic carcinoma: A 33-year single-institution experience.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18051 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18051-e18051

Author(s):

Philippos Apolinario Costa ◽

Daniel Pelaez ◽

David Tse ◽

Pasquale W. Benedetto

Keyword(s):

Adenoid Cystic Carcinoma ◽

Lacrimal Gland ◽

Tumor Size ◽

Poor Prognosis ◽

Comprehensive Cancer Center ◽

Rank Test ◽

Cancer Center ◽

Molecular Characteristics ◽

Risk Of Death ◽

Adenoid Cystic

e18051 Background: Lacrimal gland adenoid cystic carcinoma (LGACC) has historically been associated with a poor prognosis even in localized disease, with the survival of 56% at 5 years and 49% at 10 years. In 1988, our group treated the first patient with neoadjuvant intra-arterial chemotherapy (IACC) followed by adjuvant chemoradiation. Since then, we use this protocol as the standard approach for localized LGACC. Herein, we aim to analyze the clinical characteristics and outcomes of LGACC patients at a single academic institution treated with the protocol to provide information on this approach's efficacy. Methods: We prospectively assessed all patients with pathologically confirmed LGACC treated at Bascom Palmer, Sylvester Comprehensive Cancer Center, or Jackson Memorial Hospital between 1988 and 2021. We calculated overall survival (OS) using the Kaplan-Meier and Cox proportional-hazards modeling methods with Log-Rank Test to estimate the 95% confidence interval. Results: 42 LGACC patients were identified, and 37 (88%) underwent IACC, with 2 (5%) being metastatic at the time of the protocol. In our cohort, the median follow-up was 10 years, 21 (56%) were men, and the median age at diagnosis was 42 (range 20-72). The average tumor size was 3cm (range 0.8-7.6). The dominant histological pattern was cribriform (n = 23, 54%), followed by basaloid (n = 6, 14%) and solid (n = 6, 14%). 16 patients underwent whole genome sequencing, and the most common mutations found were NOTCH1 (n = 7, 41%), ATM (n = 4, 25%), BPTF (n = 4, 25%), FGFR 2 (n = 3, 18%), Frem3 (n = 3, 18%), and NOTCH2 (n = 3, 18%), with additional biomarker data forthcoming. The 5, and 10-year survival rates were 85% (95% CI 73–97) and 71% (95% CI 53-89), respectively, giving and overall mean survival of 23 years (95% CI 19–28). The risk of death was higher with a tumor size larger than 3 cm and with bone invasion (HR: 6.5 and 7.5 respectively; P < 0.05). Conclusions: Despite the historically described poor prognosis, patients with LGACC treated with IACC have an excellent prognosis. Future research on tumor molecular characteristics might identify susceptibility to targeted therapies such as NOTCH or FGFR inhibitors that could be incorporated into the IACC protocol, further extending its benefits.

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Adenoid Cystic Carcinoma of Lacrimal Gland

JMS SKIMS ◽

10.33883/jms.v15i1.124 ◽

2012 ◽

Vol 15 (1) ◽

pp. 76-77

Author(s):

Mohd Athar ◽

K S Sodhi ◽

S Kala ◽

R K Maurya ◽

S Chauhan ◽

...

Keyword(s):

Local Recurrence ◽

Natural History ◽

Adenoid Cystic Carcinoma ◽

Salivary Glands ◽

Hard Palate ◽

Clinical Course ◽

Fatal Outcome ◽

Minor Salivary Glands ◽

Adenoid Cystic ◽

History Of

Adenoid cystic carcinoma is a relatively uncommon tumour of salivary, glands and is characterised by a prolonged clinical course and a fatal outcome. It was first described as `cylindroma' by Billroth in 1859. Half of these tumors occur in glandular tissues other than the major salivary glands; principally in the hard palate, but they can also arise in the tongue and minor salivary glands. Unusual locations include the external auditory canal, nasopharynx, lacrimal glands, breast, vulva, esophagus, cervix and Cowper glands. The long natural history of this tumor and its tendency for local recurrence are well known. JMS 2012;15(1):76-77.

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Faculty Opinions recommendation of Neutron radiotherapy for adenoid cystic carcinoma of the lacrimal gland.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718033594.793485162 ◽

2013 ◽

Author(s):

Michael Kazim ◽

Carisa Petris

Keyword(s):

Adenoid Cystic Carcinoma ◽

Lacrimal Gland ◽

Adenoid Cystic

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Gastric cancer with repeated metastasis in the colonic lumen: a case report and multi-surgical experience

Journal of International Medical Research ◽

10.1177/03000605211018420 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110184

Author(s):

Yi Wang ◽

Peiqing Ma ◽

Kan Liu ◽

Dongkui Xu ◽

Qian Liu

Keyword(s):

Gastric Cancer ◽

Gastric Carcinoma ◽

Poor Prognosis ◽

Partial Gastrectomy ◽

Radical Resection ◽

Surgical Experience ◽

Colonic Lumen ◽

Poorly Differentiated ◽

Gastric Stump Carcinoma ◽

Peritoneal Spread

Poorly differentiated gastric adenocarcinoma is commonly associated with lymph node metastasis, peritoneal spread, and liver metastasis but rarely with intraintestinal metastasis. Most patients with metastatic gastric carcinoma are unable to undergo surgical treatment and have a poor prognosis. A 42-year-old man with hunger-related abdominal pain was diagnosed as having gastric cancer. After the first surgery (distal partial gastrectomy) and the second surgery (gastric stump carcinoma (GSC) resection), the patient suffered repeated multiple intracolonic metastases and underwent three additional resection operations. The patient survived for 154 months after the first operation. In patients with gastric carcinoma that metastasizes to the colonic lumen, radical resection, if possible, can extend survival. Once patients develop extensive extraintestinal metastasis, radical resection cannot be performed, and patients often exhibit a poor prognosis.

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Delayed treatment of bacteremia during the COVID-19 pandemic

Diagnosis ◽

10.1515/dx-2020-0114 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Taiju Miyagami ◽

Yuki Uehara ◽

Taku Harada ◽

Takashi Watari ◽

Taro Shimizu ◽

...

Keyword(s):

Blood Culture ◽

Delayed Diagnosis ◽

Chest Ct ◽

Blood Cultures ◽

Emergency Unit ◽

Medical Providers ◽

Delayed Treatment ◽

Clinical Measures ◽

Primary Measure ◽

Antimicrobial Administration

Abstract Objectives Coronavirus disease (COVID-19) blindness, that is, the excessive consideration of the disease in diagnosis, has reportedly led to delayed diagnosis of some diseases. We compared several clinical measures between patients admitted for bacteremia during the two months of the COVID-19 pandemic and those admitted during the same period in 2019. We hypothesized that the pandemic has led to delayed treatment of bacteremia. Methods This retrospective observational study compared several measures undertaken for patients who visited the emergency unit in two hospitals between March 1 and May 31, 2020, during the COVID-19 pandemic and whose blood cultures tested positive for bacteremia with those for corresponding patients treated during the same period in 2019. The primary measure was time from consultation to blood culture/antimicrobials. Results We included 29 eligible patients from 2020 and 26 from 2019. In 2020, the time from consultation to antimicrobial administration was significantly longer than in 2019 (mean [range], 222 [145–309] min vs. 139 [102–179] min, p=0.002). The frequency of chest computed tomography (CT) was significantly higher in 2020 (96.6 vs. 73.1%, p=0.021). Significant differences were not observed in the time to blood culture or chest CT preceding the blood culture between the two periods. Conclusions Our findings suggested that due to the COVID-19 epidemic/pandemic, focusing on the exclusion of its infection using CT scans leads to an overall delay in the diagnosis and treatment of bacteremia. Medical providers must be aware of COVID-19 blindness and evaluate patients objectively based on rational criteria and take appropriate action.

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