Abstract
BackgroundWe describe four cases of primary lacrimal adenoid cystic carcinoma (ACC) treated with neoadjuvant intra-arterial chemotherapy (NAIC).MethodsThe outcomes and complications of NAIC were reviewed. Several treatment-related local and/or systemic complications were noted.ResultsOne patient experienced ipsilateral eyelid and eyeball necrosis and permanent facial palsy; the second patient developed ipsilateral facial swelling and jaw claudication; and the third patient had febrile neutropenia, cellulitis, and phlebitis. These three patients underwent total exenteration. The fourth patient experienced neutropenia and thrombocytopenia and underwent tumour removal without exenteration. All patients were followed for more than 4 years and were alive at the last follow-up.ConclusionNeoadjuvant intra-arterial chemotherapy may be an alternative treatment that will improve the survival rate of ACC. However, careful and close observation is needed to minimise the risk of side effects. Further investigations are needed to justify the use of chemotherapy-related treatments and the associated costs.
Highlights
We describe four cases of primary lacrimal adenoid cystic carcinoma (ACC) treated with neoadjuvant intra-arterial chemotherapy (NAIC)
The aim of the present study was to report the complications related to NAIC
All patients agreed to the NAIC following full discussion of the poor prognosis of the disease, current treatment strategy, complications related to NAIC, and the uncertainty regarding the effectiveness of the treatment
Summary
We describe four cases of primary lacrimal adenoid cystic carcinoma (ACC) treated with neoadjuvant intra-arterial chemotherapy (NAIC). Primary lacrimal adenoid cystic carcinoma (ACC) is a rare, aggressive, malignant epithelial cancer with reported survival rates of less than 50% at 5 years and 20% at 10 years [1,2]. The Severance Hospital, we usually perform total exenteration, neighbouring bone resection, adjuvant radiation therapy, and systemic chemotherapy in patients with ACC. Such aggressive treatments should be considered due to the poor prognosis of ACC [1,2]. Advances in imaging technology have enabled the detection of this cancer at an early stage Supplementary treatments, such as radiation therapy and chemotherapy, play an important role in enhancing survival rates by preventing recurrence and metastasis. In 1998, Meldrum et al [3] first introduced the concept of neoadjuvant
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