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We report the findings in a patient with shortness of breath due to pulmonary hypertension five years after left pneumonectomy. Mediastinal recurrence of an incompletely resected and slowly growing adenoid cystic carcinoma of the left main bronchus had encased the right main pulmonary artery.
A case report of adenoid cytic carcinoma of the palate is presented. The clinical manifestations, diagnostic criteria, surgical resection, and prosthetic reconstruction of the patient are discussed.
Primary adenoid cystic carcinoma of the jaws is a rare neoplasm of salivary gland origin with only nine cases having been previously reported. It is characterized by a slow clinical course and insidious growth pattern that frequently results in metastasis or recurrence, or both. The example presented here was associated with retained root fragments in the mandibular molar region and had a classic histologic pattern.
A patient was referred by her dentist to the author for the evaluation of a left palatal mass and orofacial anesthesia. The author diagnosed a maxillary sinus malignancy and anesthesia of the maxillary branch of the left trigeminal nerve. Thoroughly examining the maxillary sinus of each patient who has anesthesia of the maxillary branch of the left trigeminal nerve is important in the early detection of adenoid cystic carcinoma.
The occurrence of adenopathy in patients with myelodysplastic syndrome-associated extramedullary myeloid cell tumors has rarely been reported. We describe a 7-year-old girl with juvenile myelomonocytic leukemia who showed the novel chromosomal abnormality t(9;12)(p22;q24.1) and who developed severe adenopathy of the cervical lymph nodes, tonsils, and adenoids that was manifested as granulocytic sarcoma. Following chemotherapy, the patient underwent a conditioning regimen of busulfan, cyclophosphamide, and total body irradiation followed by successful allogeneic bone marrow transplantation from her single HLA locus-mismatched mother at 6 months after her diagnosis. The patient continues to be well and in remission 3 years after stem cell transplantation.
An immunoperoxidase staining technique was used for detecting three major iron-binding proteins (transferrin, ferritin and lactoferrin) in 54 adenoid cystic carcinomas (ACCs) of major and minor salivary glands. Twenty-three normal salivary glands were investigated for comparison. Transferrin staining was detected mainly in the intercalated duct and serous acinar cells, and was found inconsistently in the myoepithelial cells surrounding normal ductules. Ferritin was always absent in the normal epithelial component of salivary gland. The presence of lactoferrin was demonstrated in the serous acinar cells and intercalated duct cells of normal salivary tissues. Five histological patterns were found in ACC, and for the cellular components of each, it was possible to establish a special immunohistochemical profile. Transferrin positivity was detected in the small angular cells of 25 cases (48%), in the duct luminal cells of 19 cases (37%) and in the hyalinized stroma of 4 cases (8%). Ferritin staining was positive in the small angular cells of 23 cases (44%) and in the duct luminal cells of 15 cases (29%). Lactoferrin was detected in only duct luminal cells of 38 ACCs (73%). The comparative immunohistochemical analysis between transferrin and ferritin showed a similar distribution in this carcinoma. On the basis of the immunohistochemical data, lactoferrin might be used as a marker of glandular differentiation.
This case report presents the clinical picture, diagnostic methodology, and surgical treatment of a 30 years old female patient, who presented with hoarseness of voice and difficulty in breathing. Direct laryngoscopy showed mass in right side of subglottic region, and biopsy-proven adenoid cystic carcinoma. Total laryngectomy was performed and patient was discharged three weeks postoperatively and doing well.
We present a case of adenoid cystic carcinoma of the trachea. The tumor could not be resected due to extensive progression but it was effectively treated endoscopically with a Nd-YAG Laser followed by 70 Gy of conventional radiotherapy. Histologically-confirmed complete remission was achieved, and the patient has lived for nearly 9 years without recurrence of disease.
A 62-year-old Japanese male patient presented with right oculomotor, abducens, and trigeminal nerve disturbances. Neuroimaging revealed a right middle cranial fossa mass lesion with the characteristics of trigeminal schwannoma. The patient underwent a right temporal craniotomy for gross total resection. Histological examination confirmed a metastasis of adenoid cystic carcinoma (ACC). After the operation, no evidence of the primary lesion could be found. The patient was treated with radiation therapy. ACC can be difficult to identify before histological confirmation. The incidence of intracranial invasion of ACC is 4-22%, but in this case no evidence of the primary lesion was found.
Adenoid cystic carcinoma (ACC) of the breast is a rare variant of breast malignancy and is known to have an excellent prognosis. We report two cases of ACC diagnosed by preoperative fine-needle aspiration cytology (FNAC), which proved to be very useful in determining the appropriate treatment. The patients were a 57-year-old woman (case 1) and a 71-year-old woman (case 2). On physical examinations and imaging studies both tumors were recognized as lobulated tumors that measured 3.0 x 2.3 cm (case 1) and 3.9 x 3.4 cm (case 2) respectively. FNAC materials showed clusters of malignant cells surrounding globules of mucus, therefore, ACC was diagnosed. Considering the characteristics of ACC, breast-conserving surgeries with axillary dissection and adjuvant radiotherapy were performed instead of primary chemotherapy or mastectomy. Histologically, a distinctive biphasic pattern was observed that consisted of true laminae and pseudocystic spaces. Tumor sizes were 4.0 x 3.3 cm (case 1) and 4.6 x 3.8 cm (case 2), respectively, and surgical margins were negative on microscopic examination. Lymph node metastasis was not present in either case. Even though ACC is very rare, preoperative diagnosis can be made based on its characteristic features. Preoperative diagnosis is extremely useful for determining appropriate treatment.
Cefaclor given per os 20 mg/kg body weight was readily absorbed and distributed to adenoid tissue and to middle ear effusion in children with chronic OME. The levels obtained were above the MIC values of most strains of respiratory pathogens. The penetration characteristics were the same after the first and the 20th dose in a b.i.d. regimen. Elimination was completed within about 12 h. The double dose, 40 mg/kg body weight, did not give higher levels but a longer duration.
This ultrastructural study is based on nine cases of adenoid cystic carcinoma arising from the salivary glands. Electron microscopically, the tumors consisted of five cell types: relatively differentiated intercalated duct cells, secretory cells, undifferentiated cells, cells of a squamous nature, and myoepithelial cells. Special attention was paid to the characteristic extracellular substances noted by light microscopic examination of these tumors. The hyaline material of the pseudocysts contained not only mucopolysaccharide granules but also fingerprint-like structures formed by replicated basement membrane. Some of these structures had a dense core, probably composed of mucopolysaccharide granules. Cell islands surrounded by elasticlike material also were found. The true lumina were usually filled with membranovesicular structures originating from fragments of the lining cells, mainly those with squamous differentiation. These membranovesicular structures included electron-dense rods, filamentous whorls, and structures displaying periodicity.
A review of 82 cases of adenoid cystic carcinoma in the head and neck is given. Radical surgery was carried out in 33 patients and yielded the best long-term results. Radiation therapy was given to 43 patients for inoperable tumour, local recurrence or, postoperatively, for sub-clinical disease. It proved especially valuable in obtaining remissions from local recurrence.
A congenital parotid gland tumor involving the facial nerve was excised, revealing histologic and ultrastructural features of a basal cell adenoma and adenoid cystic carcinoma. An asynchronous regional metastasis was successfully eradicated with adriamycin. Seven other similar appearing tumors occurring in neonates are documented in the literature and serve to establish this tumor as a clinicopathologic entity. The surrounding parotid gland had "dysplastic" changes attributed to obstruction during morphogenesis.
Adenoid cystic carcinoma (ACC) of the Bartholin gland is an uncommon malignant gynecological tumor. Brain metastasis from a malignant gynecological lesion is encountered rarely and the prognosis for this type of metastasis is poor. Different treatment protocols, such as resection, stereotactic radiosurgery, whole-brain radiation therapy (WBRT), and chemotherapy, are available and should be considered on an individual basis. In this article, the authors report a case of brain metastasis from an ACC of the Bartholin gland that was treated by resection and WBRT. A review of the literature did not reveal any other such case.
Hybrid carcinoma of the salivary gland is a very rare entity that has been described only in the parotid and palate. The occurrence of a hybrid carcinoma of maxillary sinus has not been reported. The diagnosis of hybrid carcinoma is important particularly when the components of tumor have different biologic behaviors. Diagnosis and treatment require a high index of suspicion, especially when the tumor is an epithelial-myoepithelial carcinoma, pathological effort to look for a more aggressive accompanying tumor, and proper oncologic treatment. We describe a case of 26-yr-old woman with a hybrid carcinoma composed of epithelial-myoepithelial carcinoma with an adenoid cystic carcinoma component (cribriform pattern) in the right maxillary sinus with a brief review of the relevant literature.
A case of adenoid cystic carcinoma of the prostate gland in a 38-year-old Korean man is described. Microscopically, variable patterns, that is, glandular, trabecular, cribriform and solid areas, were seen. The unusual location of this tumor in our patient highlights the ubiquitous distribution of this malignant neoplasm.
Mucosae-associated lymphoid tissues are richly innervated and the mucosae contain peptidergic nerve endings associated with different types of cells and macrophages. The lymphatic tissue is known to interact with the nervous system and several organs, implicated in the host response to a wide range of stressors, and is also richly innervated. We focussed our attention on the immune organs with particular regard to the human adenoid lymphatic tissues in order to investigate the neuroimmune links and the possible existence of relationships among different neurotransmitters and lymphocytes, macrophages, epithelial cells and nerve fibers by testing the expression of certain neurotransmitters and neurotrophins (NTs) with their own receptors.