Laryngeal Preservation in Managing Advanced Tracheal Adenoid Cystic Carcinoma

A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally.

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Does adjuvant radiotherapy for primary adenoid cystic carcinoma of the parotid gland reduce the risk for loco-regional recurrence and associated morbidity?

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(00)80454-x ◽

2000 ◽

Vol 48 (3) ◽

pp. 325 ◽

Cited By ~ 1

Author(s):

J.S Eshleman ◽

P.D Brown ◽

R.L Foote ◽

S.E Strome

Keyword(s):

Parotid Gland ◽

Adenoid Cystic Carcinoma ◽

Adjuvant Radiotherapy ◽

Regional Recurrence ◽

Adenoid Cystic

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Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach

Journal of Neurosurgery ◽

10.3171/2015.1.jns142462 ◽

2016 ◽

Vol 124 (1) ◽

pp. 115-121 ◽

Cited By ~ 22

Author(s):

Rohan Ramakrishna ◽

Shaan M. Raza ◽

Michael Kupferman ◽

Ehab Hanna ◽

Franco DeMonte

Keyword(s):

Adenoid Cystic Carcinoma ◽

Skull Base ◽

Adjuvant Radiotherapy ◽

Multidisciplinary Approach ◽

Residual Disease ◽

Univariate Analysis ◽

Progression Free Survival ◽

Cancer Center ◽

Adenoid Cystic ◽

Md Anderson

OBJECT Adenoid cystic carcinoma (ACC) is a locally aggressive tumor of salivary gland origin. Little data exist to guide treatment when this tumor extends to involve the structures of the skull base. METHODS Fifty-one patients with a diagnosis of ACC affecting the skull base were identified from a prospective database at MD Anderson Cancer Center (from 1992 to 2010). RESULTS Median follow-up for study patients was 6.75 years. The 5- and 10-year overall survival (OS) rates were 78% and 50%, respectively. Sixty-six percent of patients had progression of their disease. The 5- and 10-year progression-free survival (PFS) rates were 46.7% and 21.0%, respectively. Gross-total resection was achieved in 75% of patients, with 49% having microscopically negative margins at the time of first operation. On univariate analysis, resections with microscopically negative margins were associated with a significant OS advantage (20.1 ± 3.3 years) compared with resections that left residual disease, even if microscopic (10.3 ± 1.6 years, p = 0.035). In patients who underwent reoperation, the effect persisted, with improved OS in those with negative margins (21.4 ± 0.0 vs 16.7 ± 4.0 years, p = 0.06). The use of adjuvant radiotherapy was associated with an OS advantage (16.2 ± 2.5 vs 5.5 ± 2.2 years, p = 0.03) at initial diagnosis and improved PFS (7.8 ± 1.0 vs 2.1 ± 0.62 years, p = 0.005), whereas repeat irradiation provided no benefit. The use of adjuvant chemotherapy at diagnosis or at recurrence was not associated with any significant advantage. Multivariate analysis revealed margin-negative resection at initial operation and at recurrence retained OS significance, even after controlling for age, radiation therapy, and T stage. CONCLUSIONS ACC of the skull base is best treated with a multidisciplinary approach aimed at maximal, safe resection. Adjuvant radiotherapy should be offered, whereas chemotherapy does not confer benefit.

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Adenoid Cystic Carcinoma of Larynx: A Case Report and Rare Experience

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1129 ◽

2016 ◽

Vol 6 (2) ◽

pp. 86-88

Author(s):

Nitin Gupta ◽

Arjun Dass ◽

Hitesh Verma ◽

Surinder K Singhal ◽

Rajpal S Punia ◽

...

Keyword(s):

Case Report ◽

Respiratory Distress ◽

Adenoid Cystic Carcinoma ◽

Adjuvant Radiotherapy ◽

Rare Case ◽

Adenoid Cystic ◽

Laryngeal Tumors ◽

Carcinoma Of Larynx

ABSTRACT Adenoid cystic carcinoma (ACC) accounts for less than 1% of laryngeal tumors. Surgery is the treatment of choice which can be combined with adjuvant radiotherapy. We present a rare case of ACC of glottis and subglottis presented to us with respiratory distress. How to cite this article Verma H, Dass A, Punia RS, Singhal SK, Gupta N, Bhutani M. Adenoid Cystic Carcinoma of Larynx: A Case Report and Rare Experience. Int J Phonosurg Laryngol 2016;6(2):86-88.

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A Case of Tracheal Adenoid Cystic Carcinoma Treated by Sleeve Resection of the Trachea through Median Sternotomy Incision

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.59.52 ◽

2008 ◽

Vol 59 (1) ◽

pp. 52-55 ◽

Cited By ~ 1

Author(s):

Yoshinori Shitara ◽

Shigebumi Tanaka ◽

Yasunori Ishibashi ◽

Takeshi Yoshida ◽

Takeshi Negishi ◽

...

Keyword(s):

Adenoid Cystic Carcinoma ◽

Median Sternotomy ◽

Sleeve Resection ◽

Adenoid Cystic

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Impact of Tumor Site and Adjuvant Radiotherapy on Survival of Patients with Adenoid Cystic Carcinoma: A SEER Database Analysis

Cancers ◽

10.3390/cancers13040589 ◽

2021 ◽

Vol 13 (4) ◽

pp. 589

Author(s):

Jason Tasoulas ◽

Kimon Divaris ◽

Stamatios Theocharis ◽

Douglas Farquhar ◽

Colette Shen ◽

...

Keyword(s):

Overall Survival ◽

Salivary Gland ◽

Adenoid Cystic Carcinoma ◽

Submandibular Gland ◽

Adjuvant Radiotherapy ◽

Clinicopathological Parameters ◽

Seer Database ◽

Adenoid Cystic ◽

Mechanistic Investigation ◽

The Impact

Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor, displaying aggressive behavior with frequent recurrence and metastasis. Little information exists regarding the impact of clinicopathological parameters and adjuvant radiotherapy (aRT) on ACC disease specific (DSS) and overall survival (OS). We extracted demographic, treatment, and survival information of 1439 patients with major or minor intraoral salivary gland ACC from the Surveillance, Epidemiology, and End Results (SEER) database. The associations between tumor characteristics and aRT with OS and DSS were estimated using hazard ratios (HR) and 95% confidence intervals (CI). Submandibular gland ACCs had the worst prognosis (adjusted DSS HR = 1.48; 95% CI = 0.99–2.20, compared to parotid), and this difference was more pronounced among patients with advanced-stage tumors (adjusted DSS HR = 1.93; 95% CI = 1.13–3.30). aRT was associated with increased overall survival only among stage III submandibular ACC patients (HR = 0.64; 95% CI = 0.42–0.98) and had no benefit in any other group. In conclusion, submandibular gland ACC carries a worse prognosis than other gland subsites and may benefit from aRT. The different outcomes between submandibular gland and other major or minor gland ACCs warrant further mechanistic investigation.

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