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The authors present a case of a woman aged 31 with carcinoma adenoides cysticum at external auditory canal. The tumor was surgically removed; after 9 month a recrudescence was ascertained but there were no metastasis to other organs. The tumor was once more surgically removed. Now it has been a year of observation and no renewal of neoplastic process was noticed.
A 40-year-old woman underwent excision of the right parotid gland tumor in 1988. The pathological examination showed adenoid cystic carcinoma. In 1993 she underwent excision of a recurrent tumor on the right face and was referred to our department because of an incidental finding of left renal tumors. She underwent nephrectomy and was diagnosed with left renal metastasis on pathological examination. In 1997 computerized tomography demonstrated multiple metastases in the right kidney, liver, lungs and brain. She died of cancer in 1998. Secondary carcinoma of the kidney is usually identified at autopsy and represents a late and poor manifestation of primary disease when diagnosed during life. The present case is unique in its primary site, pathology and clinical course.
OBJECTIVE: To study the effect of laminin (LN) on invasive and metastastic behaviors of salivary adenoid cystic carcinoma (Acc) cell lines. METHODS: Immunohistochemistry, Boyden chamber in vitro motility, and adhesion test were used. LN and LNR (LN receptor) distributions in Acc-2 and Acc-M cells were studied with immunohistochemical staining. RESULTS: There were less LN and LNR found in Acc-2, but much more LN and LNR were present in the highly metastatic clone Acc-M. With the presence of exgenous LN, Acc-2 became activated showing a higher migration rate. The cell adhesion test showed that Acc-2 had stronger ability of adhesion than Acc-M with the presence of LN. CONCLUSION: The result suggests LN and LNR may play a vitral role in the invasion and metastasis of Acc.
OBJECTIVE: To study morphological variations of basment membrane component (BMC) for determination of invasion and vascular metastasis in adenoid cystic carcinoma (ACC). METHODS: The BMC of 8 cases in ACC and 2 cases of normal parotid gland were observed by LM and EM. RESULTS: The BMC surrounding tumor mass and strands showed multi-layered or dissolution, pseudopodia were seen extended from tumor cells, and contained numerous microvesicles. If the tumor cell attached blood vessels, the collagenous fibril were dissoluted and BMC were lost. CONCLUSION: The tumor cell may release some digestive enzymes which may be able to dissolve BMC and collagenous fibrils and invade into blood vessels and metastasis take place.
OBJECTIVE: To investigate the relationship between Cathepsin-D(Cath-D) and the prognosis of patients with salivary adenoid cystic carcinoma (SACC). METHODS: The immunoactivity of Cath-D of 52 cases with SACC was determined by immunohistochemistry method (Streptavidin-Biotin method). The relationship between Cath-D and the histological type, clinical stage, local recurrence, distant metastasis of the tumor and survival rate of the patients with SACC were analysed. RESULTS: Statistical analysis showed that the expression levels of Cath-D were correlated positively with distant metastasis potential and clinical stage (P < 0.05), and had no significant relation with histological type, local recurrence and survival rate (P > 0.05). CONCLUSIONS: Cath-D can facilitate invasiveness and distant metastasis of SACC; evaluation of Cath-D can act as a predictor of distant metastasis of SACC and direct the clinical treatment.
OBJECTIVE: To study factors influencing survival rate of adenoid cystic carcinoma (ACC) of the salivary glands. METHODS: One hundred and twelve cases were followed up for move than ten years and were studied to investigate factors influencing the survival rate of patients. Statistical analysis was performed using a computer program (Survcalc, John Wiley Co.). The data were statistically treated for survival curves according to the kaplan-meier method. The log rank tests were employed to assess the statistical significance of various groups. RESULTS: The age of the patients younger than 50 years old, early clinical stage, glandular/tubular histological type and tumor without nerve involvement had the best prognosis. Age of the patients older than 50 years old, ACC in the submandibular gland, advanced clinical stage (stage III and IV), solid histological type and tumor with nerve involvement had a poor prognosis. CONCLUSIONS: Age of the patients, tumour site, clinical stage, histological type and with or without nerve involvement are the important factors influencing the prognosis.
OBJECTIVE: To investigate the invasion mechanism of adenoid cystic carcinoma (ACC) by ACC haptotaxis changes in fibronectin (FN). METHODS: Three strains of ACC cells were used. The haptotaxis changes in FN, and receptor changes in the cell membrane surface were determined. RESULTS: All three strains of ACC cells had remarkably greater migration ability than SCC cell. High level of alpha 2, alpha 3, alpha 6 and beta 1 receptor subunit types was found in the cell surface of ACC and SCC; and high level of alpha 5 in ACC3. High inhibition of haptotaxis reaction was found after blocked alpha 5 and beta 1 receptor subunit in ACC and a middle inhibition after blocked alpha 4. In SCC more strong inhibition was found after blocked alpha 1, alpha 4 and beta 1. CONCLUSIONS: This study indicates that ACC cells have greater invasion ability than SCC cells in FN and haptotaxis reaction of different receptor of tested cells in FN have some feature pattern.
OBJECTIVE: To study the effects of HSV-tk/GCV system on adenoid cystic carcinoma (ACC) in vivo. METHODS: The cell strain of ACC-M (highly metastatic to the lung) was inoculated into the flank of nude mice, then treated with HSV-tk/GCV system. RESULTS: The system can inhibit the tumor growth greatly, moreover this function has bystander effect. CONCLUSION: HSV-tk/GCV system can be to treat ACC.
A case of adenoid cystic carcinoma located in trachea, primarily wrongly recognized as a thyroid cancer is presented with an update of the literature. The patient underwent surgical treatment (total thyroidectomy, and partial resection of trachea). Histopathological examination found trachea as a primary location of ACC and thyroid tumour as a metastatic one. After operation the patient underwent radiotherapy. Literature review found ACC of trachea as a very rare malignant tumour, and no such a case was presented in the past.
BACKGROUND & OBJECTIVE: The recurrence and metastasis after treatment of adenoid cystic carcinoma was usually observed in the clinical practice. There is no good indicator to evaluate the prognosis of ACC at present. This study was designed to investigate the relationship between the expression of cell adhesion molecules E-cadherin (E-cad) and proliferating cell nuclear antigen (PCNA) and prognosis in the patients with ACC. METHODS: The expression of E-cad and PCNA in 34 patients with ACC were detected by immunohistochemical staining. RESULTS: The 5-year survival rate of the patients was significantly lower in solid type of ACC than in cribriform or tubular type (P < 0.01). Clinical stages were significantly related to local recurrence and/or distant metastasis of the tumor (P < 0.01) and to 5-year survival rate of the patients with ACC (P < 0.01). Absent or low E-cad expression (50.0%) was observed more frequently in ACC with local recurrence and/or distant metastasis and with less than 5-year survival period (P < 0.05). The rate of local recurrence and/or distant metastasis of the tumor was significantly higher in high PCNA expression group (P < 0.005) than in low PCNA expression group, while the 5-year survival rate of the former was significantly lower (P < 0.005). The expression of E-cad was in high correlation with that of PCNA (P < 0.005). CONCLUSIONS: E-cad, PCNA expression, and clinical stages could be regarded as effective indices for evaluating the prognosis of ACC. E-cad may cooperate with PCNA in the malignant development of ACC.
OBJECTIVE: To test the antimetastatic effects of Arg-Asp (RD) on salivary adenoid cystic carcinoma (SACC-LM) in vivo. METHODS: RD was administered orally to experimental metastasized nude mice. The pulmonary metastatic foci number and survival were determined to assay the antimetastatic effects of RD. RESULTS: 30 mg/kg, 120 mg/kg of RD demonstrated an inhibitory effect on the pulmonary metastatic foci formation. All of the tested dosages (7.5 mg/kg, 30 mg/kg, 120 mg/kg) of RD prolonged the survival. CONCLUSIONS: Oral administration of RD has a antimetastatic effect on SACC-LM. RD is low toxicity.
Malignant tumors of the temporal bone are rare neoplasms. Adenoid cystic carcinoma (ACC) is the most common malignant tumor of minor salivary glands, while a quite rare tumor of the major. It is considered a slow-growing tumor with a course that is characterized by local recurrences and late distant metastases to lungs (80-90%), bone and liver. When metastases occur in bone especially the spine, the course of disease is usually fulminant. Intracranial involvement can occur by direct extension, hematogenous or perineural spread and represents an advanced stage of the disease. In this paper, we present a rare case of temporal bone ACC reporting for the first time simultaneous bony and pulmonary distant metastases. The origin, the pathology, the imaging techniques, the differential diagnosis, the treatment options and the prognosis of these tumors are discussed.
OBJECTIVE: To investigate the expression of the basement membrane proteins in adenoid cystic carcinoma (ACC) of the salivary glands and discuss the relationship between the expression of the proteins and the differentiation as well the prognosis of ACC. METHODS: 101 patients which were confirmed pathologically were collected and made a follow-up, and 30 cases of them were selected to detect the basement membrane proteins (type IV collagen, fibronectin, laminin and heparan sulfate proteoglycan) by the means of immunohistochemistry. RESULTS: The cribriform pattern of ACC had a more favorable prognosis than the solid pattern which had a lower rates of metastasis of/and recurrence. The positive locations and the degrees of the four proteins varied with the histological patterns of ACC. The cribriform pattern had the strongest positive expression and the solid pattern the weakest. In addition, the staining of fibronectin were weaker in all three patterns of ACC. CONCLUSION: The degree of the positive expression of the four proteins has a negative relation to the differentiation of the tumor cells. The lower degree of differentiation the tumor cells are, the weaker positive signals they express. Of the four substances in the basement membrane, laminin is the main material which adhere the parenchymal cell to the collagen in basement membrane of the tumor. Basement membrane proteins could be regarded as one of the basis to evaluate the prognosis of ACC.
OBJECTIVE: To study the effects of herpes simplex virus thymidine kinase(HSV-tk) gene transduction on adenoid cystic carcinoma(ACC) cells. METHODS: Gene transduced cells were detected with growth rate, scanning electronic microscope, transmission electronic microscope, cell cycle analysis and the expression of major histocompatibility complex(MHC) class I or II molecules. RESULTS: The parameters detected in gene transduced cells and parental tumor cells were similar. CONCLUSION: The HSV-tk gene transduction would not change the biological characters of tumor cells greatly.
OBJECTIVE: The protein kinase C (PKC) family of isoforms plays the key role in the regulation of cellular events, including cell proliferation, differentiation and canceration. Previous work from our laboratory has shown the alteration of PKC and its inhibitor activities in salivary adenoid cystic carcinoma (SACC) [Sun Changfu, et al. West China Journal of Stomatology, 1998, 16(3): 201-203]. This study aimed to further explore the relationship between PKC isoforms and canceration of SACC. METHODS: Expressions of five isoforms of PKC (alpha, beta I, beta II, epsilon and delta) were examined in cytosolic and membranous fraction of specimen homogenates from SACCs and were compared with the adjacent normal tissues by immunoblotting. Equal amounts of cytosolic and membrane protein from control and experimental groups were simultaneously subjected to sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE), transferred to nitrocellulose membranes, and reacted with first and second antibodies; Color development and image analysis were performed. RESULTS: 1. Cytosolic PKC-alpha, PKC-beta I, and PKC-beta II were expressed in SACCs and adjacent normal tissues. The Expressions of these three cytosolic isoforms were reduced significantly in SACCs compared with the adjacent normal tissues; 2. Membranous PKC-alpha was only detected in SACCs and the membranous translocation of cytosolic PKC-alpha was also seen. 3. The expressions of PKC-epsilon and PKC-delta were not detected in both SACCs and adjacent normal tissues. CONCLUSION: There was close relationship between changes of expression of PKC isoforms (alpha, beta I, beta II) and carcinogenesis of SACC. We postulated that there may be relationship between the membranous translocation of PKC-alpha and hematogenous lung metastasis in SACC.
OBJECTIVE: To study the possibility of neuroendocrine feature of salivary adenoid cystic carcinoma (SACC). METHODS: Immunohistochemical staining was operated in SACC with S-100 protein, Neuron-specific enolase (NSE), chromagranin A and synaptophysin which are specific and correlative with neuroendocrine and neoplasias. RESULTS: The positive expression of S-100, NSE, chromogranin and synaptophysin were respectively 42, 32, 8 and 7 in 50 cases of SACC. CONCLUSION: There is possibility of neuroendocrine feature in some SACC cells.
Cells from the human adenoid cystic carcinoma (ACC) line, KOA-1, originating from the minor salivary gland and showing histological features of a dominantly solid pattern of ACC, were transplanted into the subcutaneous tissue of nude mice. The occurrence of lung metastasis was then examined both histologically and by PCR with a human-specific base arrangement of the beta-globin gene. Histologic examinations revealed lung metastasis in 5 of 30 mice. On the other hand, PCR showed a higher positive rate: 26 of 67 mice (0/10 at 1 month, 5/15 at 2 months, and 21/42 at 3 months after the transplantation). When some lungs which showed positive results by PCR analysis were transplanted into other mice, KOA-1 tumors developed. The results suggested that this experimental model could be a standard in vivo model of metastasis of human ACC.
Adenoid cystic carcinoma of the mammary gland is considered a rare entity with a favourable prognosis, accounts for < 1% of the breast malignancies. We report herein the case of a 57 year old woman who presented a breast mass. A mastectomy with axillary lymph node dissection was performed. None of 15 axillary lymph nodes contained metastases, and the patient remains well and free from recurrence 12 months after her operation.