Adenoid Carcinoma Research Articles

Minor salivary gland tumours: a 10-year study

Salivary gland tumours represent between 2% and 6.5%, approximately, of all head and neck tumours. The aim of this paper was to identify the frequency of minor salivary gland tumours among patients in the Oral Medicine Clinic of the Federal University of Paraná during the period from 1997 to 2007. A retrospective study was conducted on 1923 histopathological analyses of oral lesions. Fourteen cases of salivary gland tumours were found, of which 7 were benign and 7 malignant. The lesions were localized mainly in the palate (71.5%). By histological type, 50% of the lesions were characterized as pleomorphic adenoma, 28.6% mucoepidermoid carcinoma, 14.3% cystic adenoid carcinoma, and 7.1% as polymorphous adenocarcinoma. These findings suggest that salivary gland tumours have a low incidence in the population and that the pleomorphic adenoma is the most common type of tumour, followed by mucoepidermoid carcinoma.

Tracheal Malignant Melanoma: Successful Outcome With Tracheal Resection

Primary tracheal malignant melanomas are uncommon neoplasms: only five cases have been reported. Different therapeutic approaches are described, with a short life expectancy observed. We report a case of a young woman with a primary tracheal malignant melanoma who underwent complete tracheal resection and is free of disease 4 years after surgical treatment.

Clinical review of cases with parotid tumors

We report a clinical review of 212 cases whose parotid tumors had been treated at our department between April 1991 and May 2008. Their age, gender, histological type, stage classification, and surgical methods were reviewed and then the results of treatment and diagnostic methods were discussed with bibliographical study. Mean age of benign cases was 51.4 years old and that of malignant cases was 55.9 years old. The number of cases was 194 (92 men and 102 women) and 17 (9 men and 8 women), respectively. Eighty-six percent of histological types were pleomorphic adenoma and Warthin's tumor. Eight percent were parotid carcinomas, including mucoepidermoid, adenoid cystic, and adenoid carcinomas. Treatment was selected for each case from surgical operation, post-operative radiotherapy, chemotherapy, and combined therapy. The five-year survival rate of parotid carcinomas was 63.0%. Five cases with poor outcome showed higher stages of disease and higher grade of tumor. Two of them showed pre-operative metastasis and two other cases had facial nerve dysfunction. Based on the evaluation of poor outcome cases as well as bibliographical study, we finally concluded that significant prognostic factors for patients with primary parotid carcinoma are: stage of disease, grade of tumor, pre-operative metastasis, and facial nerve dysfunction. As for availability of fine needle aspiration cytology for preoperative diagnosis, a comprehensive diagnosis including clinical symptoms, image data, and pathological findings of frozen section is required, because we found a few false negative cases.

Immunohistochemical phenotype of cutaneous cribriform carcinoma with a panel of 15 antibodies

We report a cribriform carcinoma of the left fossa poplitea in a 62-year-old woman. The patient did not present any symptoms, and the only complaint was the nodule, which was resected for diagnosis. After considering different diagnostic options, we decided that the most appropriate one was cribriform carcinoma, which is an entity described in 1998. The diagnostic criteria, which were provided in the few publications that refer to this entity, helped us to distinguish it from the main mimicker: cystic adenoid carcinoma. Owing to the cribriform pattern of the tumor, we also looked for a metastasis from other sites, mainly breast, vulva, and salivary glands, but all these were clinically excluded. The tumoral cells showed secretion by decapitation, as well as a positive stain of the luminal secretion by histochemical techniques of Alcian blue and periodic acid-Schiff. The tumor was negative for iron stain. In spite of these characteristics, which are, for some authors, indicative of an apocrine phenotype, the immunohistochemical study revealed some differences with the profile that has been described in cases of apocrine adenocarcinoma. The tumor did not express GCDFP-15 or CD 15. It was also negative for SMA, CEA, and PR. The pattern of cytokeratins expressed by our case was positive for AE1-AE3, CAM 5.2, and CK7, without any expression for CK20. Other markers expressed by the tumor were EMA, ER, c-erbB-2, p53, and S-100.

Quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms

This study was aimed at assessing the quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms (MSGN). Twelve patients (10 women and 2 men, mean age: 49.4 years) with histopathologic diagnosis of pleomorphic adenoma (PA, 3 cases), polymorphous low-grade adenocarcinoma (PLGA, 2 cases), cystic adenoid carcinoma (CAC, 4 cases), and muco-epidermoid carcinoma (MEC, 3 cases) were evaluated. All of them were treated by surgical excision; patients with CAC received radiotherapy as well. The patients quality of life was evaluated through a self-administered questionnaire concerning their physical well-being, emotional status, normal daily activities, and family relationships. The results showed that patients with MEC--the youngest among all patients--reported a significantly greater worsening of their physical well-being and emotional status after treatment as compared with patients treated for PA (P<0.05), and also of their functional activities as compared with those treated for PA and PLGA (P<0.05). In conclusion, age of development of the neoplasm and type of disease produce more impact on patients quality of life than does the therapys degree of aggression.

Perineural Invasion through the Maxillary Division of the Right Trigeminal Nerve in a Rare Case of Nasolabial Malignant Peripheral Nerve Sheath Tumor

We report the CT and MR imaging findings in a patient with malignant peripheral nerve sheath tumor in the right nasolabial area, which exhibited typical imaging features of cystic adenoid carcinoma.

Facial reconstruction in the case of a cystic adenoid carcinoma of the hard palate

A 46-year-old Caucasian patient was admitted to our department with a palatal mass. Maxillofacial CT scan findings and biopsy revealed a malignant accessory salivary gland tumour of the right hemi-palate extending to the anteriorly to the right maxillary sinus, laterally to the pterygoid apophysis and superiorly to the orbit rim. A large surgical tumourectomy was performed. The reconstruction consisted in an inverted temporalis muscle flap, a buccinator muscle flap and a polylactic resorbable plate.

Suppression of salivary adenoid cystic carcinoma growth and metastasis by ErbB3 binding protein Ebp1 gene transfer

Ebp1, an ErbB3 binding protein and downstream effector of the ErbB signaling network was shown to be a potent tumor suppressor in breast and prostate adenocarcinomas. We hypothesized that the inhibitory properties of the ebp1 gene could also be beneficial if ectopically expressed in salivary adenoid carcinoma. Salivary adenoid carcinoma cell line (ACC-M) cells were stably transfected with the full-length ebp1 cDNA sequence or the empty expression vector pcDNA3.1. Stable gene transfer was verified by Western blot analysis and reverse transcription (RT)-PCR. A significant reduction in cell proliferation, anchorage-independent growth, and a change in the cell cycle profile was observed in ebp1 transfectants. Matrigel assays demonstrated that the adenoid cystic carcinoma cell invasiveness was significantly reduced. A strong decrease in the metastatic potential of human adenoid cystic carcinoma cells in an experimental metastatic model was also observed. Our results suggest that ectopic expression of Ebp1 mediates multiple antitumor activities against adenoid cystic carcinoma cells and that ebp1 gene therapy might be a viable method suppressing malignant salivary adenoid tumors.

Carcinoma adenoide quístico de mama: a propósito de un caso

Objective To describe an unusual and infrequent type of breast carcinoma with specific defining characteristics. Case report We present the case of a woman with cystic adenoid carcinoma and review the literature published on this entity to date. Results The behavior of this tumor in relation to other breast tumors, and its clinical management and treatment are analyzed. Conclusions Cystic adenoma of the breast is a distinct clinicopathological entity from infiltrating ductal or lobular breast carcinoma. Its treatment is not based on parameters that are determinant in other breast cancers. Its outcome and biological behavior seem more favorable.

Overexpression of SCC antigen and cyclins in an adenoid squamous carcinoma cell line derived from the maxillary sinus

Squamous cell carcinoma antigen (SCC-Ag) is produced by the two almost identical, tandemly arrayed genes, SCCA1 and SCCA2. In this study, we investigated the mechanism of increased expression of SCC-Ag in a cell line SCCMM derived from an aggressive adenoid SCC with high titer of SCC-Ag in the patient serum. The differential polymerase chain reaction using specific primers for SCCA1 and SCCA2 revealed no gene amplification in SCCMM. However, RT-PCR demonstrated that levels of SCCA1 and SCCA2 mRNAs in SCCMM were 80- and 120-fold higher than those in CaSki as a reference SCC cell, respectively. Western blot analysis showed that the levels of these two SCC-Ag proteins in SCCMM were 15-fold higher than those in CaSki, suggesting that expression of the SCC-Ag in SCCMM was controlled at both the transcriptional and post-transcriptional levels. To investigate highly malignant character of SCCMM, expression of cell cycle regulatory proteins was investigated by Western blotting. Cyclin E and cyclin B1 were expressed at approximately 100-fold higher levels in SCCMM than in CaSki, but Cip/Kip cyclin-dependent kinase inhibitors (CDKIs) were expressed at low levels and p16 and p19 ink4 CDKIs were not detected. These results suggest that the aggressive growth of SCCMM is due, at least in part, to large increases in cyclin E and cyclin B1 expression with low levels of CDKIs.

左手掌のａｃａｎｔｈｏｌｙｔｉｃ ｓｑｕａｍｏｕｓ ｃｅｌｌ ｃａｒｃｉｎｏｍａ 早期に転移・死亡した症例

Acantholytic squamous cell carcinoma (ASCC) was first described under title of “adeno-acanthoma of sweat glands” by Lever in 1947. Today it recognizes one type of the squamous cell carcinoma. The tumor commomly occurred in exposed areas, particularly near the head and neck regions in elderly persons. The microscopic feature of ASCC is acantholysis with formation of lumens containing dyskeratotic cells toward the center of the lobule. Johnson et al. reported there was metastasis in 3 patients among 155 patients. But Nappi et al. described cases did metastasize widely and prove fatal were 19%. The tumor size of greater than 1.5 cm correlate with the risk of an adverse outcome. We had experienced a case of 80-year-old male who had raised tumor on the left palm and one year after first operation he was dead to metastasize lymphnode of axilla, liver, kidney and costal bone. Histological finding of palm's tumor showed acantholysis with the lumens containing dyskeratotic cells. But lymphnode's histology showed adenoid carcinoma pattern. Further immunohistochemical examination proved metastatic cells in lymphnode was ASCC. We have discussed the importance of early surgical treatment and lymphnode dissection of ASCC compared with SCC. [Skin Cancer (Japan) 2000; 15: 108-112]

A CASE OF ADENOID CYSTIC CARCINOMA OF THE TRACHEA

A 61-year-old woman was admitted to the hospital because of dyspnea. There was a previous history of undergoing a thyroidectomy for a thyroid tumor at elsewhere. On admission, airway stricture sound was heard at her throat, and respiratory function tests revealed a mixed ventilatory dysfunction. CT scan of the neck demonstrated a solid mass with clear margin that occupied about 90 percent of the tracheal lumen. Laryngeal fiberscopy showed an easy-bleeding tumor that nearly obstructed the tracheal lumen. A resection of trachea from first ring to fifth ring with end-to-end anastomosis was performed. Histologically, the tumor was cystic adenoid carcinoma arising from the tracheal gland. It penetrated the tracheal wall and extended the adjacent tissues. Postoperative radiation therapy with total dose of 50 Gy was given. She has been well without any signs of recurrence for 1 year after the operation.

Anesthesia for Tracheal Resection: A New Technique of Airway Management in a Patient with Severe Stenosis of the Midtrachea

Anesthesia for Tracheal Resection: A New Technique of Airway Management in a Patient with Severe Stenosis of the Midtrachea

Anesthesia for Tracheal Resection: A New Technique of Airway Management in a Patient with Severe Stenosis of the Midtrachea

We report the combined use of a Fogarty catheter (FC), a 3.5-mm fiberoptic bronchoscope (FOB), and a 6.0 endotracheal tube (ETT) to intubate the lower trachea of a patient with a primary upper- and midtracheal tumor causing a 66% stenosis of the tracheal lumen at the level of the thoracic inlet. Initially, the 6.0 ETT, with the FOB and the FC fed to its tip, was placed above the tumor and rotated 90° counterclockwise. The FOB and the FC were advanced through the stenosis, and the FC cuff was inflated just above the carina. The ETT was advanced over the FOB toward the FC cuff, and the ETT cuff was inflated below the tumor and above the FC cuff. After inspection for blood and tumor debris through the FOB’s eyepiece, the FC cuff was deflated, both the FOB and FC were withdrawn, and intermittent positive pressure ventilation (IPPV) was begun.

Subcranial fronto-orbito-nasal approach for ethmoidal cancers: Surgical techniques and results

Background The authors report their experience with the subfronto-orbito-nasal approach (SFON) for the treatment of 30 patients suffering from ethmoidal cancers over the past 3 years. The advantages and pitfalls of this technique are described and compared with other classic approaches. Methods Among 156 patients suffering from ethmoidal cancers and treated between January 1984 and January 1998, 30 patients were operated on using the SFON approach during the past 3 years. There were 27 males and 3 females, ranging in age from 15 to 77 years. Histologic composition of the lesions was as follows: 15 adenocarcinomas, 6 esthesioneuroblastomas, 3 melanomas, 2 epidermoid carcinomas, 1 nondifferentiated carcinoma, 1 neuroendocrine carcinoma, 1 villous carcinoma, and 1 cystic adenoid carcinoma (cylindroma). According to the authors’ classification, 7% were T1, 6% T2, 22% T3, 38.5% T4a, and 26.5% T4b. All patients were operated on through a SFON approach, followed by removal of the tumor and reconstruction of the skull base with a pericranial flap. Results Since the mean follow-up was of short duration (12 months, ranging from 3 to 29 months), significant carcinologic results could not be obtained. However, a detailed analysis of the surgical procedure was performed. No patient died or had major complications related to the SFON approach. One cerebrospinal fluid (CSF) fistula and four oculomotricity dysfunctions were observed. Definitive anosmia was reported in all cases. Conclusion The advantages of the procedure include a wide exposure of the anterior skull base through a limited approach, the possibility of modifying the approach according to the size and location of the lesion, total resection of tumors, simplified skull base reconstruction technique, and reduction of postoperative confusion and hospital stay.

Characteristics of the antitumor activity of cepharanthin against a human adenoid squamous carcinoma cell line

Characteristics of the antitumor activity of cepharanthin against a human adenoid squamous carcinoma cell line

Adenoid Cyctic Carcinoma in the Head and Neck

30 cases of adenoid cystic carcinoma (ACC) in the head and neck region were studied. They were arising in 13 major salivary glands (parotid 5, submandibular 4, sublingual 4), 9 nose and paranasal sinuses (maxilla 3, maxilloethmoid 1, ethmoid 3, sphenoid 1, nasal cavity 1), 5 oral cavities (tongue base 2, floor of the mouth 2, palate 1), 1 larynx, 1 external auditory canal, and 1 unkown. The presenting symptoms were a mass without pain in 25%, mass with pain in 17.9%, and pain in 17.9%. Mean duration of symptoms was 22 months. Only three patients had Stage I, each seven patients had Stage II or III, and 13 patients had Stag IV. 23.3% of the patients died of disease, with a mean survival period of 44 months. Histologic specimens were reviewed and divided into 3 subtypes-tubular, cribriform, and solid. 3 patients had tubular subtype, 22 and 5 patients had cribriform and solid subtype. In 25 out of 28 treated cases surgery was done, with 9 of them considered as curative one. Combination chemotherapy with cyclophosphamide, adriamycin, and cis-platinum was done in 9 cases with a response rate of 11.1% (1/9). Radiation therapy was done in 8 cases in total with a response rate of 100% (2/2). Radiation therapy accompanied with chemotherapy containing cis-platium was done in 2 cases with a response rate of 50% (1/2). Cumulative survival rate for 5 and 10 year was 50% (8/16) and 16.7% (1/6) respectively. Factors which appeared to influence the clinical course included 1) presense or absence of metastasis, 2) clinical stage, with absenseof metastasis, and lower clinical stage to have better prognosis.

唾液腺腫ようにおけるＳＣＣ抗原の発現

Immunohistochemical localization of SCC antigen was investigated to evaluate its usefulness as a tumor marker in salivary gland disease. SCC antigen levels were measured in both sera and tissues from 14 salivary disease patients. SCC antigen was confirmed to be localized in cancer cells of mucoepidermoid tumors and adenoid carcinomas, but was not present in adenoid cystic carcinomas. In pleomorphic adenoma, SCC antigen displayed interesting localization patterns; the antigen localized in the ducts, squamous epithelium and keratin formations. However, it was absent in the myxomatous area and myoepithelium cells. Therefore, SCC antigen was found to be impractical as a tumor marker in salivary gland tumors for two reasons;(a) There was no localization in adenoid cystic carcinoma, and (b) Serum SCC antigen levels were low in salivary malignant disease patients. On the other hand, this study suggests that the investigation of tissue SCC antigen can be useful for differential diagnoses of salivary gland diseases and also in the application of the study of their origin and differentiation.

Spontaneous Urinary Bladder Tumors in DA/Han Rats: A Feasible Model of Human Bladder Cancer

In a life-span study of virgin DA/Han inbred rats, 53.9% of the males and 14.4% of the females developed spontaneous urinary bladder tumors. A peak incidence was noted between the ages of 25 and 30 months. With the exception of 1 leiomyosarcoma, all neoplasms were of epithelial origin. After the papilloma, the majority of tumors were classified as transitional cell carcinoma of the papillary, solid, or mixed type. Less frequent were unclassified microcarcinoma, squamous cell, adenoid, and undifferentiated carcinomas. A sexual difference was found for almost every tumor type. Of the rats bearing tumors, 3.5% of the males and 64.4% of the females also were affected with urinary bladder stones. Squamous cell and glandular metaplasias of the tumors commonly were observed, and invasive growth into the bladder wall occurred frequently in less-differentiated tumors. Metastases were rare. The DA/Han rat strain is discussed as a suitable animal model for human urinary bladder cancer.

Involvement of the mamillae in breast cancer

500 cases of carcinoma of the female breast were analysed in connection with the problem whether there is any involvement of the mamilla in this disease. The mamilla was found to be involved in 98 cases (19.6%), the incidence rate of this involved increasing with advancing age. A comparison of the types of carcinoma showed that the largest group (44%) was represented by the solid carcinomas. The percentage of carcinoma distribution was approximately the same as the share of mamilla involvement, with the exception of adenoid carcinoma. Only 12% of the mamillae were involved with a tumour diameter of less than 3 cm, whereas in the case of larger carcinomas the percentage was 30%. The distance between tumour and mamilla is also important. If the mamilla was affected, the homolateral axilla was also affected in 54% of the cases, but this figure dropped to 27% if the mamilla had remained free. This leads to the conclusion that while a conservative, non-radical surgical treatment is fundamentally possible, the selection and the formation given to the patients must be done with great care. The problem of multicentricity remains. Long-term comparisons have not been made so far.