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PubMed2003

[Adenoid cystic carcinoma of the major and minor salivary glands. Retrospective analysis of 74 patients].

PURPOSE: In this study we give a clinical review of our experience with adenoid cystic carcinoma (ACC) and compare our results with those reported in the literature. PATIENTS: Between 1981 and 2000, 74 patients with ACC of the head and neck were treated at the Department of Oral and Maxillofacial Surgery, Hannover Medical School. RESULTS: The average age at diagnosis was 58 years. There were 38 men and 36 women. The primary site was the parotid gland in 4 cases, the submandibular and sublingual gland in 21 cases, the lacrimal gland in 1 case, the minor salivary glands of the oral cavity and oropharynx in 44 cases, and the nasal cavity and maxillary sinus in 4 cases. There were 19 T1, 15 T2, 9 T3, and 31 T4 tumors with perineural invasion of 32 tumors. R0 resection was performed in 45 cases. Fourteen patients received postoperative radiation. There were only five N1 and two N2b necks. All patients were staged M0 at presentation. Local control rates at 5, 10, and 15 years were 64%, 56%, and 52% with a mean local control time of 11.1 years. Tumor size ( p< or =0.001), margin status ( p< or =0.001), and perineural invasion ( p</=0.001) showed significant influence on local control. However, we were not able to demonstrate a positive effect of postoperative radiation. Distant control rates at 5, 10, and 15 years were 72%, 62%, and 59% with a mean distant control time of 14.4 years. Distant failure was diagnosed in lungs and bones and occurred independently of local treatment outcome. Overall survival rates at 5, 10, and 15 years were 71%, 54%, and 37% with a mean overall survival of 11.2 years. Recurrence-free survival rates at 5, 10, and 15 years were 57%, 45%, and 37% with a mean recurrence-free survival of 9.1 years. The survival rates at 5, 10, and 15 years after diagnosis of tumor progression were 35%, 15%, and 0% with a mean survival time of 4.7 years. CONCLUSION: Our results provide insights on the unusual nature of these tumors, which may be useful for making clinical decisions. However, prospective randomized studies are needed to define the optimal treatment for patients with ACC with special regard to adjuvant treatment modalities.

Adolescent↗
PubMed2004

The potential role of breast conservation surgery and adjuvant breast radiation for adenoid cystic carcinoma of the breast.

PURPOSE: Adenoid cystic carcinoma (ACC) of the breast is a rare breast cancer variant and optimal management is unclear. A review of this unusual tumour was performed at our Institution, to assess the role of breast conservation in the management of this disease. METHODS AND MATERIALS: A review of all cases of ACC of breast (1960-2000) treated at Princess Margaret Hospital (PMH) was undertaken. Information was collected on age at diagnosis, presenting features, tumour size and treatment modalities. Treatment outcomes were evaluated. RESULTS: Eighteen female and one male patient were identified. Median age at diagnosis was 58 years (range 35-76 years). Four patients had lymph-node positive disease at presentation; the single male patient presented with metastatic disease. Surgery was either a lumpectomy (10 cases) or a simple, radical or modified radical mastectomy (9 patients). Nine of 19 patients received adjuvant radiotherapy (RT). The median follow-up time was 14 years; the recurrence rate at 10 years was 31% (95% CI 7-54%) with a range in time of recurrence from 2.3 to 11.9 years. Seven recurrences were identified (4 local, 1 regional, 2 metastatic). Two of these patients developed metastatic spread and died. Six of the 19 cases went on to develop second malignancies of whom four died. Among the 18 female patients, the 10-year overall (OS), cause-specific (CSS), and relapse free survival (RFS) rates were 75, 100, and 46% respectively. CONCLUSIONS: ACC of the breast has a relatively prolonged natural history, and responds well to conservative management at presentation, with good outcome, even following local recurrence.

Adult↗
PubMed1975

Adaptation of the mandible in children with adenoids.

In a sample of lateral x-ray cephalograms of children with obstructing adenoids, a dorsal rotation of the mandibular ramus was found to characterize the facial skeleton. The mandibular body and the condylar process were not correspondingly rotated. The findings suggest that dorsal rotation of the mandible occurring in association with various pathologic processes could always be primarily a response to an encroachment of the pharyngeal space. A possible involvement of the clivus region, to a minor degree, was also indicated. The need for "tailormade" cephalometric methods in studies of specific problems is stressed.

Adenoidectomy↗
PubMed1979

Adenoid cystic carcinoma of the salivary glands. A study of ninety-three cases.

The present study reviews ninety-three cases of adenoid cystic carcinoma of the major (80 cases) and minor (13 cases) salivary glands occuring in ninety-one patients. This tumor is insidious in its presentation and subsequent clinical course with early perineural lymphatic invasion and late metastases. Many patients remain alive but with recurrent disease. The high incidence of recurrent disease (parotid gland 20 of 47, submaxillary gland 20 of 33, and minor salivary glands 7 of 11) suggests inadequate initial surgery at all anatomic sites. Misdiagnosis (16 cases) on frozen or permanent section has led to less than optimum primary treatment. The frequency of perineural lymphatic involvement with recurrence (11 of 19 cases) suggests that the tumor may be extending along the nerve roots in an anatomic area with extensive nerve distribution (the head and neck). Radical neck dissection, in our studies, has contributed to improved survival rates when the primary site has been the submaxillary gland. The treatment of recurrent disease has been primarily surgical (3 operations per patient), and palliation with prolonged survival has been achieved with radical excision of recurrence. The fifteen year determinate cure rate of 19 per cent in comparable to that reported in the world literature. Radiation therapy has been helpful in palliation but has not been curative. Radiation treatment was used for recurrence in twenty-seven patients, and the average time from radiation treatment to death was 3.8 years.

Adolescent↗
PubMed1986

Atypical manifestations of pulmonary adenoid cystic carcinoma.

Pulmonary adenoid cystic carcinoma (PACC) typically arises in large airways. A patient who presented with a peripheral lung mass due to PACC is reported. She was found to have multiple pulmonary nodules due to PACC 11 years after resection of the original tumour. We emphasize that 10-15% of patients with PACC present with peripheral tumours.

Carcinoma, Adenoid Cystic↗
PubMed1984

Isolation of follicular dendritic cells from human tonsils and adenoids. I. Procedure and morphological characterization.

Follicular dendritic cells have been isolated from human tonsils and adenoids and characterized at the ultrastructural level. Follicles were dissected and digested with different hydrolytic enzymes. The cells were separated by sedimentation at unit gravity. By this procedure we obtained follicular dendritic cells enveloping lymphocytes with their cytoplasmic extensions in a way analogous to that described for isolated thymic nurse cells. The ultrastructural features of isolated follicular dendritic cells are similar to those observed in situ. Prolonged enzymatic action caused loss of the enveloped lymphocytes.

Adenoids↗
PubMed1976

Multifocal adenoid cystic carcinoma of the lip.

A 62-year-old Caucasian woman had several distinct and separate adenoid cystic carcinomas which involved both sides of the upper lip. Microscopic examination of the surgical specimens suggested that at least one of these malignant neoplasms arose from a pre-existing basal-cell adenoma.

Carcinoma, Adenoid Cystic↗
PubMed1976

Adenoid cystic carcinoma of minor salivary gland. Histochemical and electron microscopic studies of cystlike space.

Five cases of adenoid cystic carcinoma of minor salivary glands were studied. The mucoid material in the characteristic cystlike space of this neoplasm was distaseresistant periodic acid-Schiff (PAS)--positive, alcain blue-positive, toluidine blue-positive, and mucicarmine-positive. Verhoeff-Van Gieson's method and Weighert's method did not reveal elastic tissue in the cystlike spaces. Mallory's method revealed that a central core in cystlike spaces was similar in stainability to collagen. Wilder's method did not reveal reticular fibers in these spaces. Electron microscopy revealed three readily recognizable zones: a juxtacellular zone of a network of replicated basal lamina, and intermediate zone of stellate granules of mucoid material, and a central core of densely packed aperiodic filaments or collagen fibrils. The histogenesis of cystlike spaces and their realtionship with biologic behaviors of the neoplasm were discussed.

Carcinoma, Adenoid Cystic↗
PubMed1976

Adenoid cystic carcinoma. Analysis of fifty oral cases.

Fifty cases of oral minor salivary gland adenoid cystic carcinoma (ACC) are analyzed and reported. Oral ACC frequently masquerades as a benign neoplasm, and in the majority of cases there is no pain or ulceration. The most common location is in the palate; a plea is made for incisional biopsy of all oral lesions suspected of salivary gland origin. Survival rates show a progressive decrease with time, and there were no survivors beyond 20 years. In this study, there was a positive correlation between duration of the lesion before diagnosis and the salvage rate, but no correlation was found with the size of the presenting lesion.

Adult↗
PubMed1977

Adenoid cystic carcinoma of the salivary gland and its histologic variants. A clinicopathologic study of thirty cases.

Thirty adenoid cystic carcinomas were seen among 384 salivary gland tumors during the 24-year period from 1952 to 1975. They caused the most difficulty in diagnosis, as they showed a spectrum of histologic appearances. In addition to tumors with the typical cribriform pattern of uniform dark cells, there were some with a more solid basaloid pattern resembling basal-cell carcinomas of the skin. Others manifested both cribriform and basaloid patterns in juxtaposition. A shorter duration of symptoms in lesions with a basaloid component suggests a more rapid growth rate in such tumors. Ultrastructural examination of a tumor with a typical cribriform pattern showed spaces of two types; the more frequent type was bounded by cells with straight plasma membranes and contained filamentous and basement-membrane-like material, and the less frequent type was surrounded by cells with numerous microvilli and contained nonfilamentous homogeneous material. The filamentous and basement-membrane--like material corresponded to connective tissue mucin and the non-filamentous material to epithelial mucin in the light microscopic sections.

Adenoma, Pleomorphic↗
PubMed1985

Adenoid cystic carcinoma of the upper lip.

An elderly man had a large adenoid cystic carcinoma (ACC) of the upper lip. Because of the patient's desire not to have a major surgical resection, the primary modality of treatment was irradiation. A local recurrence following radiation therapy did require surgery, however without morbidity. During the postoperative course extreme physical deterioration of the patient necessitated a complete medical work-up. This revealed lung nodules, not seen previously, which were suspected of being malignant. A barium enema also revealed a sigmoid lesion suggestive of malignancy. Since none of the suspected distant sites were histologically examined, the course of the ACC is left to conjecture. Also, it is left to conjecture as to what course might have followed had the patient been treated initially with a surgical resection. The patient died 20 months after the original diagnosis of the lip tumor was made.

Aged↗
PubMed1990

Solid adenoid cystic carcinoma of the maxilla.

Seven cases of solid variant of adenoid cystic carcinoma of the maxilla are reported. Clinical and radiographic characteristics suggest origin within the maxillary alveolar bone. Swelling was minimal and disproportionate to the extensive, diffuse bone destruction universally present. Histologic features were typical of this neoplasm occurring in other sites and consisted of diffusely infiltrating islands of small, closely packed monomorphous cells with sparse cytoplasm, indistinct borders, and small hyperchromatic nuclei. Four of five patients with follow-up data died of their disease. This confirms the lethality of the solid variant. Rationale is presented for considering these malignancies to be of primary intraosseous origin.

Adult↗
PubMed1990

Adenoid cystic carcinoma of the palate in a 9-year-old boy.

Malignant tumors of salivary glands in children are extremely rare. A case of an adenoid cystic carcinoma affecting the palate in a 9-year-old child is described. This tumor has not previously been reported as affecting the minor salivary glands among patients in this age group.

Carcinoma, Adenoid Cystic↗
PubMed1992

Analysis of adenoid cystic carcinoma treated by radiotherapy.

The records of 41 patients with adenoid cystic carcinoma of the head and neck region who had been treated with radiotherapy were reviewed. Local control was achieved in 72.3% in the cases with primary lesions at 5 years. The prognosis for tumors that arose in the major salivary glands was better than that for tumors that arose in the minor salivary glands; however, the difference was not statistically significant. In the minor salivary glands, early-stage tumors were well controlled with the use of radiation therapy alone. In spite of the high local control rate, the disease-free survival rate of the patients at 10 years was only 20.8%. Lung metastasis determined the prognosis.

Brachytherapy↗
PubMed1983

Metastatic-adenoid cystic carcinoma of the major salivary glands presenting as a spinal cord tumor.

An adenoid cystic carcinoma (cylindroma) of the submandibular salivary gland presented 17 years after diagnosis with a compressive syndrome of the spinal cord as well as a local recurrence. This is the first reported case of such an occurrence. The literature is reviewed concerning other malignant tumors of the salivary glands presenting in this way. Fifteen cases of mixed salivary-gland tumors are reviewed. Evidence of histologic change from one tumor type to another and the mechanism of spread to the vertebral column is discussed.

Carcinoma, Adenoid Cystic↗
PubMed1985

Adenoid cystic carcinoma of the cervix: a report of 17 cases.

Seventeen cases of adenoid cystic carcinoma of the cervix are presented. The long-term survival was in early stage IB-IIA. Patients with more than stage IIB had no survival rate over 5 years. One thing of interest was the fact that lung metastasis was 29.4%.

Adult↗
PubMed1985

Cervical adenoid cystic carcinoma associated with ascites.

Two new cases of cervical adenoid cystic carcinoma are reported. The addition of these two cases brings the total number of reported cases in the literature to 88 making this the most common gynecologic site of occurrence for this unusual tumor. Ascites developed in both of these cases after primary radiation therapy. The significance of this unique association is discussed.

Aged↗