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PubMed2006

[Adenoid cystic carcinoma of the lacrimal gland in a 14-year-old girl].

The discovery of unilateral exophthalmia requires multidisciplinary care made all the more difficult in the case of a 14-year-old girl living in a tropical environment. The child, C.A., resident of the town of Djenné in Mali, was examined for nonpulsate, nonretractile, left lateral unilateral exophthalmia, painful upon palpation of a left upper-external mass under the orbital rim. The initial examination highlighted the existence of an intraorbital tumor with a moderate effect on visual function. In view of the slow and progressive development over 2 years, and with the assistance of an association, the child was transferred to a specialized medical structure where the tumorous nature was confirmed after surgical exeresis. The diagnosis was cylindroma, or adenoid cystic carcinoma. Neither chemotherapy nor radiation were used. At 15 months after surgery, the child showed no clinical sign of recurrence. Intraorbital tumors in children present diagnostic and therapeutic problems in countries with limited medical resources. Cylindromas or adenoid cystic carcinomas of the lachrymal gland are the second most common cause of epithelial tumors in this gland, which are characterized by a high degree of malignancy, a very high rate of recurrence, and a low survival rate at 5 years. In a tropical environment, diagnostic and therapeutic difficulties are compounded by limits to comprehensive care for the child.

Adolescent↗
PubMedDate not supplied

Human interferon production in tonsil and adenoid tissue cultures.

Using Sendai virus as an inducer, tonsil lymphocytes produce alpha interferon (IFN-alpha) 1,000 times more potent than that reportedly induced using Newcastle disease virus in such lymphoid tissue. Alpha and gamma interferons can be produced from tonsil and adenoid lymphocyte cultures in amounts comparable with those produced from cultures of pooled peripheral blood lymphocytes. Lymphocytes from both tonsils and adenoids are equal in the amount of IFN each produces. The IFN-producing potential of lymphocytes appears constant in humans between the ages of 3 and 38 years and is not adversely affected during the first trimester of pregnancy. Since approximately one billion lymphocytes are obtained from each of these tissues, they represent a potential source of significant quantities of IFN for investigational use.

Adenoids↗
PubMedDate not supplied

Ciliary activity on adenoids of patients with otitis media with effusion.

Ciliary activity of the adenoidal surface in patients with otitis media with effusion (OME) was evaluated by a photoelectric method. Three groups of patients were compared: a non-OME group whose members had experienced no episode of OME; a middle ear effusion (MEE)-negative OME group whose members had an episode of recurrent OME but no MEE during the month preceding the operation; and an MEE-positive OME group whose members were experiencing an episode of recurrent OME with MEEs when tissue was taken for examination. To serve as a comparison, the ciliary activity in the central pharynx of normal guinea pigs was evaluated using the same technique. The ciliary activity in all patients was significantly lower than that in normal guinea pigs. No significant difference in ciliary activity was apparent between the non-OME group and the MEE-negative OME group. However, both were significantly higher than the ciliary activity of the MEE-positive OME patients. The following findings are drawn from our data: ciliary activity on the surface of hypertrophic adenoids is depressed, and patients with OME have reduced ciliary activity compared with those who have no otitis media or those who have otitis media without effusion.

Adenoids↗
PubMed2000

Treatment of locally advanced adenoid cystic carcinoma of the head and neck with neutron radiotherapy.

PURPOSE: To examine the efficacy of fast neutron radiotherapy for the treatment of locally advanced and/or recurrent adenoid cystic carcinoma of the head and neck and to identify prognostic variables associated with local-regional control and survival. METHODS AND MATERIALS: One hundred fifty-nine patients with nonmetastatic, previously unirradiated, locally advanced, and/or recurrent adenoid cystic carcinoma (ACC) of the head and neck region were treated with fast neutron radiotherapy during the years 1985-1997. One hundred fifty-one patients had either unresectable disease, or gross residual disease (GRD) after an attempted surgical extirpation. Eight patients had microscopic residual disease and were analyzed separately. Sixty-two percent of patients had tumors arising in minor salivary glands, 29% in major salivary glands, and 9% in other sites such as the lacrimal glands, tracheal-bronchial tree, etc. Fifty-five percent of patients were treated for postsurgical recurrent disease and 13% of patients had lymph node involvement at the time of treatment. The median duration of follow-up was 32 months (range 3-142 months). Actuarial curves for survival, cause-specific survival, local-regional control, and the development of distant metastases are presented for times out to 11 years. RESULTS: The 5-year actuarial local-regional tumor control rate for the 151 patients with GRD was 57%; the 5-year actuarial overall survival rate was 72%; and the 5-year actuarial cause-specific survival rate was 77%. Variables associated with decreased local-regional control in the patients with GRD as determined by multivariate analysis included base of skull involvement (p < 0.01) and biopsy only versus an attempted surgical resection prior to treatment (p = 0.03). Patients without these negative factors had an actuarial local-regional control rate of 80% at 5 years. Patients with microscopic residual disease (n = 8) had a 5-year actuarial local-regional control rate of 100%. Base of skull involvement (p < 0.001), lymph node metastases at the time of treatment (p < 0.01), biopsy only prior to neutron radiotherapy (p = 0.03), and recurrent tumors (p = 0.04) were found to be associated with a diminished cause-specific survival as ascertained by multivariate analysis. Patients with base of skull involvement and positive lymph nodes at presentation had an increased rate of the development of distant metastases at 5 years, (p < 0.01 and p < 0.001, respectively). No statistical difference in outcome was observed between major and minor salivary gland sites. CONCLUSIONS: Fast neutron radiotherapy is an effective treatment for locally advanced ACC of the head and neck region with acceptable toxicity. Further improvements in local-regional control are not likely to impact survival until more effective systemic agents are developed to prevent and/or treat distant metastatic disease.

Analysis of Variance↗
PubMed1997

Unusual appearance of an intracranial metastatic adenoid cystic carcinoma: comedo-necrosis showed very hyperdense nodules on CT scans.

A case of intracranial metastatic adenoid cystic carcinoma with unusual hyperdense nodules in CT scans is described. A 32-year-old man had a brain tumor containing scattered and very hyperdense numerous nodules on CT scans. Initially, the hyperdense nodules were considered as intratumoral calcifications. The tumor subsequently proved to be metastatic adenoid cystic carcinoma through surgery. However, there were no calcium deposits in the surgical specimen. We observed only multiple central comedo-necrosis that could be the cause of the hyperdense lesions on CT scans.

Adult↗
PubMed1997

Massive pleural effusion as isolated manifestation of metastatic spread of salivary adenoid cystic carcinoma.

Adenoid cystic carcinoma is a low-grade malignant neoplasm that arises preferentially in the major and/or minor salivary glands. While it has a tendency to spread locally, distant metastases have been described occasionally. This case report describes a patient with a massive pleural effusion as primary manifestation of metastatic adenoid cystic carcinoma. This is a very uncommon, yet treatable, occurrence.

Carcinoma, Adenoid Cystic↗
PubMed1999

Intrasellar adenoid cystic carcinoma and papillary mucinous adenocarcinoma: two previously undescribed primary neoplasms at this site.

Most carcinomas involving the sella turcica are metastases. We report two previously undescribed carcinomas that appear to be primary at this site. The first occurred in a 44-year-old woman who presented with hemianopsia. A mass was noted by computed tomography to occupy the sella turcica, from which it appeared to originate. Transphenoidal biopsy showed the tumor to be an adenoid cystic carcinoma with a typical cribriform pattern. The patient died shortly after a subsequent attempt at tumor resection. The second tumor arose in a 55-year-old man who presented with diplopia. Computed tomography showed a mass in the sella turcica that was presumed to be a pituitary adenoma. However, transphenoidal resection revealed a mucinous adenocarcinoma composed of small papillae and glands lined by columnar epithelium. The tumor cells exhibited varying degrees of stratification with prominent interspersed mucin vacuoles. Focal solid areas showed a component of signet ring-type cells. In contrast to the apparent aggressive behavior of the adenoid cystic carcinoma, the papillary mucinous adenocarcinoma appeared much less aggressive, as the second patient was alive and without evidence of disease 5 years later. Both tumors may be derived from epithelial rests within the pituitary gland, either minor salivary gland rests or Rathke's cleft remnants.

Adenocarcinoma, Mucinous↗
PubMed2006

Evaluation of inspiratory pressure in children with enlarged tonsils and adenoids.

UNLABELLED: Children with enlarged tonsils and adenoids usually present breathing abnormalities such as snoring, mouth breathing and sleep apnea. It is known that upper airway obstruction and consequent mouth breathing may result in pulmonary diseases. AIM: The goal of this preliminary study was to evaluate the inspiratory pressure in children with upper airway obstruction due to enlarged tonsils. STUDY DESIGN: Clinical with transversal cohort. MATERIAL AND METHOD: We evaluated 37 children (4-3 years old, female/male) with enlarged tonsils who would be submitted to a T&A surgery in the Department of Otolaryngology, Medical School, University of Sao Paulo, from October 2002 to March 2003. The control group comprised 28 children without tonsillar disease submitted to the same tests. Inspiratory pressure was obtained using a manometer and vacuum meter. RESULTS: We could observe lower inspiratory pressures in children with upper airway obstruction. The mean of inspiratory pressure in the upper airway obstruction group was 14.607 cm/H2O and in the control group was of 27.580 cm/H2O. CONCLUSIONS: Enlarged tonsils and adenoids were associated with poor inspiratory pressure, resulting in increased breathing effort and work of the involved muscles.

Adenoids↗
PubMed1989

Effect of respiration on nasopharyngeal radiographs when assessing adenoidal enlargement.

Clinical assessment of adenoidal enlargement in children is difficult and so the lateral nasopharyngeal radiograph is frequently used to assess both adenoid size and the appearance of the adjacent airways. Various measurements of the soft tissues and airways can be made to assess normality or otherwise. Little previously has been mentioned about the physiological conditions, particularly the mode of respiration, under which these radiographs should be obtained and how changes in these conditions affect their appearance. The marked effect in the appearances of nasopharyngeal soft tissues and palatal airway on simply changing from mouth to nose breathing is presented, and an alternative method of examination, for use under certain circumstances is described.

Adenoids↗
PubMed1994

Mast cell ultrastructure in the adenoids of children with and without secretory otitis media.

This study was designed to compare the differences in morphology of the mast cells from the adenoid in children with otitis media with effusion (OME) and those from children with recurrent tonsillitis. Tissue for electron microscopy was prepared in the standard manner and between three and 10 blocks were examined for each child. All the mast cells with nuclei were photographed and the condition of the granules noted. The number of electron dense granules in each cell was assessed on a scale between zero and 10. Sixteen unselected children with OME were compared with 19 children with recurrent tonsillitis. There were no obvious differences in the degree of degranulation between the two groups although there was more vacuolation than previously described in the normal nose but less than in those patients with perennial allergic rhinitis. Allergy and mast cell reactions do not seem to predispose to OME. It was concluded that the adenoids are not the ideal tissue in which to study normal mast cells.

Adenoids↗
PubMed1997

The response of adenoid cystic carcinoma to tamoxifen.

Adenoid cystic carcinoma of the parotid gland often recurs locally, or metastases develop, after initial treatment with surgery and radiotherapy. We report a patient with an inoperable local recurrence of previously irradiated adenoid cystic carcinoma, who was treated with tamoxifen, an oestrogen receptor antagonist. After 18 months of treatment with tamoxifen, MRI showed a partial response, and further clinical progression of the disease was halted.

Anticarcinogenic Agents↗
PubMed1997

Adenoid cystic carcinoma of the head and neck.

Adenoid cystic carcinoma has a long natural history but frequently proves fatal. The present study describes 108 patients with an adenoid cystic carcinoma of the head and neck seen over a 30-year period. Analysis of the data utilized both univariate and multivariate methods. Forty per cent of patients had tumours arising from the oral cavity and half of these were in the hard palate; 29% occurred in the major salivary glands; 41% of tumours were locally advanced at presentation and 11% had lymph node metastases at this time. The histological pattern was solid in 25%, cribriform in 40% and tubular in 20%. In addition, 15% of patients had a polymorphous low-grade adenocarcinoma and these were analysed separately. Primary site recurrence was more common in the presence of locally advanced tumours at presentation (T3-4) (P = 0.0093). Only six patients had surgery with adjuvant radiotherapy. Six patients had no curative treatment, 21 had primary radiotherapy, 39 had local excision and 42 radical excision. The actuarial primary site recurrence rate was 100% at 30 years. The neck node recurrence rate was 23% at 15 years. Tumour specific survival was 40% at 20 years. Solid histology had a worse prognosis than other histological types (P = 0.0429) but those patients with polymorphous low-grade adenocarcinomas fared very well. Patients with tumours of the hard palate fared better than those patients with tumours at other sites (P = 0.0301). Early disease at the primary site (T1-2) was a good prognostic sign (P = 0.0013). Patients with neck node metastases at presentation tended to do badly (P = 0.009).

Carcinoma, Adenoid Cystic↗
PubMed2001

Adenoid cystic carcinoma of the prostate: a case report with immunohistochemical and in situ hybridization staining for prostate-specific antigen.

A 43-year-old man with urinary outlet obstruction was referred to our hospital. A digital rectal examination revealed an elastic hard prostate. The serum prostate-specific antigen (PSA), serum prostatic acid phosphate and gamma-seminoprotein levels were found to be within the normal range, and transrectal ultrasound sonography provided normal findings. The patient underwent a subcapsular prostatectomy under a diagnosis of benign prostatic hyperplasia. Histopathologically, the lesion was diagnosed as an adenoid cystic carcinoma of the prostate. Because a further examination revealed a pathologic extension into the urinary bladder, a radical cystoprostatectomy was performed. The expression of PSA protein and PSA mRNA was studied by means of immunohistochemistry and an in situ hybridization technique. The adenoid cystic carcinoma in the patient did not show any positive signs for PSA protein or PSA mRNA.

Adult↗
PubMed2003

Recurrent adenoid cystic carcinoma of the scalp treated with mohs micrographic surgery.

Primary cutaneous adenoid cystic carcinoma is a rare skin neoplasm with a high potential for recurrence after local excision. We present a case of a 45-year-old white female with recurrent primary cutaneous adenoid cystic carcinoma of the scalp. The tumor was resected with Mohs surgery in two stages and defect repaired with split-thickness skin graft. There has been no recurrence of the tumor in the 12-month follow-up period.

Carcinoma, Adenoid Cystic↗
PubMed2002

The biological behaviour of human adenoid cystic carcinoma cells transduced with interleukin-2-gene.

Adenoid cystic carcinoma (ACC) of the salivary glands is a highly infiltrative malignant tumour with a tendency for lung metastasis. Gene therapy could be a potentially effective therapy for ACC and its metastasis. The aims of the study were: To transduce interleukin-2 (IL-2) gene into an ACC cell line with predisposition for lung metastasis (ACC-M); to compare the bioactivity of the gene-transduced cells and the parent cell line in vitro and in vivo. The IL-2 gene was transduced via a bicistronic retroviral vector into the ACC-M cells. The growth rate and DNA cell cycles of the parent ACC-M, the control viral vector AmGCEN, and the gene transduced AmIL-2 cell cultures were compared quantitatively and by flow cytometry, respectively. The tumourigenic ability of the three cell lines was verified by inoculation in athymic nude mice. The tumours developed were extracted and compared quantitatively and histologically. There was no difference in the growth rate and the DNA count between the ACC-M, AmGCEN, and AmIL-2 cell cultures. In the animal experiment, both the ACC-M and AmGCEN cells stimulated lung metastasis in all the mice, whereas there was no tumour found in the 1 x 10(6) AmIL-2 cells inoculation. On 3 x 10(6) AmIL-2 cells stimulation, three out of six mice developed tumours but the mass and volume of the tumours were smaller than the other two groups. Under light microscopy, the ACC-M tumours were mainly poorly differentiated with minimal cellular matrix, whereas the AmIL-2 tumours were well differentiated with ample matrix. The transduction of IL-2 gene can reduce the tumourigenicity of ACC-M cells and induces tumour cell differentiation in mice. The IL-2 gene can be a potential effective gene for the treatment of adenoid cystic carcinoma of salivary glands and its lung metastasis.

Animals↗
PubMed2006

[Adenoid cystic carcinoma secondary to heterotopic salivary gland tissue of the cervical lymph nodes].

BACKGROUND: The presence of heterotopic salivary gland tissue in intra-, periparotideal and cervical lymph nodes is not an uncommen finding. In some rare cases the salivary gland inclusions in lymph nodes may undergo neoplastic transformation. PATIENT AND METHODS: An isolated and indolent tumor was detected in level III in the right cervical area in a 60 year-old male patient. The histological assessment of the extirpated node seemed to indicate lymph node metastasis of an adenoid cystic carcinoma. The radiological and endoscopic findings did not reveal a primary tumor. RESULTS: Due to the fact of missing of a primary tumor, the diagnosis of an adenoid cystic carcinoma in heterotopic salivary gland tissue of the cervical lymph node was established after long-term observation. CONCLUSION: After exclusion of an occult carcinoma of the salivary glands, the possibility of malignant transformation of heterotopic intranodal salivary gland inclusions should be considered in patients suffering from salivary gland carcinoma in the area of the cervical lymph nodes.

Carcinoma, Adenoid Cystic↗
PubMed1993

[Hyperplastic adenoids and growth of the facial skeleton].

A case of a 16-year old female patient with large hyperplastic adenoids is presented. The only subjective symptoms were blocked nasal ventilation and subsequent permanent mouth breathing for 10 years. Concomitant sinusitis and middle ear affection were absent. In addition a gothic palate with malocclusion due to prognathism was found. The possible relationship between hyperplastic adenoids, chronic mouth breathing and craniofacial growth is discussed.

Adenoidectomy↗
PubMed1990

[A simple method for the demonstration of the bacterial spectrum in the nose and the nasopharynx in the infection-free interval in children with adenoid hypertrophy].

The implications of bacterial colonization and distribution patterns in the nasopharynx and nasal cavities of children with adenoidal hypertrophy without clinical signs of acute infection are to be determined. We examined the spectrum and distribution of the facultative pathogenic bacterial flora in nasal cavities and nasopharynx of children with clinical apparent symptoms or signs of adenoid hypertrophy in an infection free interval. Compared with the nasal cavity we found an accumulation of pathogenic bacteria in the nasopharynx. A transnasal single swab from the nasopharynx showed to be the most effectively practical way to detect clinically relevant pathogenic bacteria. A thin flexible calcium-alginate swab was used in our experiments. Swabbing from the anterior nasal cavities proved to be a minor successful diagnostic method.

Adenoids↗