Cystic Carcinoma Of Lacrimal Gland Research Articles

Research progress of biomarkers in adenoid cystic carcinoma of lacrimal gland

Research progress of biomarkers in adenoid cystic carcinoma of lacrimal gland

Lacrimal Gland Adenoid Cystic Carcinoma with High Grade Transformation: A Case Report and Current Concepts in Multi Modality Management.

Lacrimal gland adenoid cystic carcinoma (AdCC) is associated with an aggressive clinical course and grave prognosis. A high grade transformation within adenoid cystic carcinoma of lacrimal gland is a rare condition which is even more locally aggressive with frequent neck and distant metastasis. We present a case of left lacrimal gland adenoid cystic carcinoma with high grade transformation to adenocarcinoma NOS type presenting with orbital pain and proptosis. After thorough evaluation for locoregional and distant spread of the disease, the patient underwent left orbital exenteration with orbitectomy and neck dissection with free flap reconstruction. Patient received adjuvant radiation therapy and is presently disease free for last 6months. A multi-modality management protocol involving surgery, radiotherapy and chemotherapy has been proposed for management of lacrimal gland AdCC with high grade transformation. We report the 4th case in the literature of lacrimal gland adenoid cystic carcinoma with high grade transformation.

Case of Adenoid Cystic Carcinoma of Lacrimal Gland Treated by Eye Sparing Radiation Therapy using 3DCRT Technique

Case of Adenoid Cystic Carcinoma of Lacrimal Gland Treated by Eye Sparing Radiation Therapy using 3DCRT Technique

Histopathological study of adenoid cystic carcinoma in lacrimal gland

Introduction: The lacrimal gland is secretory gland situated in the lacrimal gland fossa. Adenoid cystic carcinoma of lacrimal gland is most common malignant tumor of lacrimal gland and very crucial to differentiate between adenocystic carcinoma and pleomorphic adenoma of lacrimal gland because of different outcome. Aims and Objectives: To study the incidence, histopathological pattern, and distribution into the age, sex of Adenoid cystic carcinoma in to the lacrimal gland. Materials and Methods: A Retrospective study of 14 cases of Adenoid cystic carcinoma in lacrimal gland during period of 10 years were studied A detailed history of patients were taken with special attention to the age, sex, macroscopic (gross examination) and microscopic features of tissue. Microscopic examination is done under standard H & E staining procedure. Result and Conclusion: Total 57 cases of lacrimal gland tumor were studied among them 14 cases of adenoid cystic carcinoma, its most common malignant tumor of lacrimal gland. It’s most common age for presentation is 4th to 6th decade, and most common histological pattern present in mixed pattern. And its incidence are slightly more common in female. Other detail discussed in to the result and discussion section. Keywords: Adenoid cystic carcinoma, Lacrimal gland, Histological patterns, Age, Sex.

Survival outcomes of eye-sparing surgery for adenoid cystic carcinoma of lacrimal gland.

To survey adenoid cystic carcinoma of lacrimal glands in Asian population and investigate the predictability in prognosis following the 8th edition American Joint Committee on Cancer (AJCC) staging guideline. Retrospective study. The clinical entities and surgical outcomes of the patients who were histologically confirmed with a diagnosis of lacrimal adenoid cystic carcinoma in National Taiwan University Hospital between January 1995 and December 2015 were retrospectively reviewed. Enrolled were 11 patients. The median follow-up was 7.2 years. Eight patients (72.7%) were diagnosed as T1 or T2 disease, and three patients (27.3%) were diagnosed as T3 or T4 disease according to the AJCC 8th edition guideline. Eye-sparing surgery with radiotherapy was performed in nine patients. Local recurrence was noted in six patients (54.5%) with median disease-free interval of 23.5 months. Six patients (54.5%) developed distant metastases, including lung, bone, and cranial invasions. Overall survival rate during the study period was 54.6%. Five-year overall survival was 81.8% and ten-year overall survival was 68.2%. The Log-rank test for overall survival and disease-free survival between patients with less than T3 disease (p=0.001) and patients with T3 or T4 disease (p=0.006) revealed significant differences. This study highlighted the aggressive nature of adenoid cystic carcinoma of lacrimal glands. Eye-sparing surgery with adjunctive radiotherapy may achieve relatively optimal disease control in diseases staged T1 or T2, but in advanced disease metastasis and mortality are usually inevitable.

Color Doppler ultrasound and contrast-enhanced ultrasound in the diagnosis of lacrimal apparatus tumors.

Color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in the diagnosis of lacrimal apparatus tumors were investigated. In total, 48 patients undergoing preoperative two-dimensional and color Doppler ultrasound and CEUS examinations were included in this study. Conventional ultrasound and CEUS characteristics of 48 patients pathologically and clinically diagnosed with lacrimal apparatus tumors were retrospectively analyzed. Results of conventional ultrasound of 29 cases with pleomorphic adenoma of lacrimal gland showed moderate-hypoechogenic solid masses in lacrimal gland; CEUS displayed two enhancement modes: High, fast-developed slow-extinct and overall uniform enhancement (20/29, 68.97%) and high, fast-developed slow-extinct, centripetal, uniform or non-uniform enhancement (9/29, 31.03%); after enhancement, the mass edge was clear without changes in size. Results of conventional ultrasound of 6 cases with adenoid cystic carcinoma of lacrimal gland showed hypoechogenic solid masses with unclear edge, irregular form, non-uniform echo, and abundant blood flow signals; the CEUS displayed high, fast-developed fast-extinct and overall uniform enhancement; after enhancement, mass edge was unclear and masses were larger than that in two-dimensional ultrasound. Results of conventional ultrasound of 10 cases with lacrimal sac cyst showed non-uniform, hypoechogenic masses, or cystic solid mixed masses with clear edge but no blood flow signal; the CEUS displayed peripheral circular enhancement and no enhancement inside. Results of conventional ultrasound of 3 cases with adenocarcinoma of lacrimal sac showed hypoechogenic solid masses with unclear edge, irregular form, non-uniform echo inside, and abundant blood flow signals in lacrimal sac; CEUS displayed high, fast-developed fast-extinct and overall uniform enhancement; after enhancement, masses with irregular shapes were obviously larger than that in two-dimensional ultrasound. CEUS shows the microcirculation of tumors and surrounding tissues. Combination of two-dimensional and color Doppler ultrasound can improve the preoperative qualitative diagnosis of tumors and provide references for the selection of operation methods and determination of tumor resection scope.

Long-Term Outcomes of Eye-Sparing Surgery for Adenoid Cystic Carcinoma of Lacrimal Gland.

This study's primary purpose is to assess the long-term outcomes of patients who have undergone eye-sparing surgery and adjuvant radiotherapy for adenoid cystic carcinoma of the lacrimal gland. In this retrospective analysis, clinical records were reviewed of all patients diagnosed with adenoid cystic carcinoma of the lacrimal gland, at a single institution, between March 1998 and November 2012. Ten patients were identified as having undergone eye-sparing surgery and adjuvant radiotherapy for adenoid cystic carcinoma of the lacrimal gland. Preoperative radiographic findings, treatment modalities, histological results, and patient outcomes were analyzed. There were 6 male and 4 female patients. The patients' tumors were staged according to the 8th American Joint Committee on Cancer staging system, and were as follows: 1 patient was classified as T1aN0M0; 6 patients were classified as T2aN0M0; 1 patient was classified as T2cN0M0; 2 patients were classified as T3aN0M0. All patients had a histologically confirmed diagnosis of lacrimal gland adenoid cystic carcinoma, which was confined to the orbit, and was without extension into adjacent bone marrow or other organs. All patients underwent eye-sparing tumor excision followed by postoperative radiotherapy, with a median dose of 6000 cGy (range: 5000-6600 cGy). At the last follow up, 8 patients were alive without evidence of disease. One patient was deceased at 58 months post-surgery, due to esophageal carcinoma; this was unrelated to the lacrimal gland tumor. The final patient experienced tumor recurrence in the medial orbit 53 months post-surgery, and exenteration was performed. This patient was alive, without disease recurrence, at 90 months following exenteration. The median follow-up time was 89.5 months (range: 37-217 months). Systemic metastasis did not occur in any patient. Eye-sparing surgery and adjuvant radiotherapy have demonstrated favorable local control and long-term survival outcomes in patients with orbit-confined lacrimal gland adenoid cystic carcinoma. Consequently, eye-sparing surgery with adjuvant radiotherapy can be considered as a viable treatment option for orbit-confined lacrimal gland adenoid cystic carcinoma.

Analysis of orbital malignancies presenting in a tertiary care hospital in Pakistan.

Objective:To determine the frequencies of various orbital malignancies amongst orbital lesions in patients presenting in a tertiary care hospital in Pakistan.Methods:A retrospective analysis of 666 orbital cases with an established histopathological diagnosis of malignant tumors treated in Mayo Hospital Lahore from 1996 to 2015 (20 years).Results:About 66% of the malignant tumors were primary, 25% secondary, 8% haematopoietic and 1% metastatic. Almost 50% of the cases were children. Retinoblastoma is the commonest tumor (43% overall and 87% among children). Squamous cell carcinoma is the second commonest (15.6% overall and 31% among adults). These are then followed by Adenoid cystic carcinoma of Lacrimal Gland (9%), Lymphoma/Leukaemia (8%) and Rhabdomyosarcoma (6.3%).Conclusion:Frequencies of various orbital malignancies show geographical variation in both paediatric and adult population.

Management of Lacrimal Gland Carcinoma

To review the published literature on management strategies for lacrimal gland carcinomas. Review of relevant articles in PubMed published in English from the year of 1970 through September 2014. A review of literature suggests that treatment strategies for adenoid cystic carcinoma of lacrimal gland are varied, but local control does not necessarily prevent future delayed distant relapse. Tumor size and histologic features of lacrimal gland carcinoma seem to be important prognostic features. With improved imaging modalities providing better tumor diagnosis and staging, and availability of more focused radiation delivery techniques, multimodality globe sparing management of lacrimal gland carcinomas may be possible in selected cases. The availability of targeted drugs based on the molecular signature of an individual lacrimal gland carcinoma may offer possible targeted treatments for patients with nonresectable or metastatic disease. Given the rarity of lacrimal gland carcinoma, multi-institutional studies and consistent reporting of size and histologic type of tumors in the literature may be prudent. Particularly, multimodality globe-sparing treatment strategies should be studied further.

A case report of adenoid cystic carcinoma of lacrimal gland

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that can exist in many different body sites. It is most commonly found in the areas of the head and neck, (mainly salivary glands). It is also reported in the breast, lacrimal glands of the eye, lung, brain, sinuses. It is characterized by a prolonged clinical course and fatal outcome. It was first described as `cylindroma' by Billroth in 1859. The long natural history and its tendency for local recurrence is well known. Patients may survive for years with metastases because this tumor is generally well differentiated and slow growing. We report a case of ACC of lacrimal gland. They are rare malignant tumors in a patient presenting with an orbital mass. They account for 1.6% of all orbital tumors. Despite their rarity, they are the second most frequent epithelial neoplasms occurring in the lacrimal gland after pleomorphic adenomas.

Influence of Ginkgo biloba extract on proliferation of ACC-2 cell, Survivin and TIP30 gene expression in adenoid cystic carcinoma of lacrimal gland

Exploring the influence of extract of Ginkgo biloba (EGB) on the proliferation, apoptosis of ACC-2 cell in lacrimal adenoid cystic carcinoma and analyzing the influence of EGB on the gene expression of Survivin and TIP30 based on the levels of the gene and protein. ACC-2 cell in human with ACC of lacrimal gland disposed by EGB of different concentration was in vitro cultured. MTT method was used for cell proliferation detection. Annexin V/PI double-staining flow cytometer was used to detect cell apoptosis and cell cycle. Survivin and TIP30 gene expression together with protein expression were analyzed by RT-PCR and Western blotting. And it is indicated that EGB has inhibitory effect on the proliferation of ACC-2 cell in vitro. Furthermore, the dose-effect relationship was significant. Compared with the control group, it had statistical difference (P <0.01). The inhibitory concentration 50% (ICso) is 88 mg . L-1. By flow cytometer examination, it was indicated that EGB can gradually increase ACC-2 cell in G0-G1 stage and decrease it in G2-M and S stage. With the increase of dose, the apoptosis rate of ACC-2 cell obviously increased (P <0.05 or P <0.01). Both of the expression results of RT-PCR and Western hybrid proteins have showed that the concentration of EGB increased, it could be seen a significant decrease in Survivin gene expression (P <0.01). Meanwhile, the TIP30 gene expression got a significant increase. Therefore, EGB can effectively inhibit ACC-2 cell Survivin gene expression in human with adenoid cysistic carcinoma of larcrimal gland as well as promoting TIP30 gene expression, inducing the ACC-2 cell apoptosis and inhibiting tumor cell proliferation, which provided a certain theoretical and experimental basis for the application of Chinese herbal medicinal ingredient in the treatment of tumors.

The clinical analysis of cranio-orbital communicating tumors

To investigate the clinical manifestations, imageological features, surgical approaches and prognosis of cranio-orbital communicating tumors. The retrospective analysis was performed in the 22 patients of cranio-orbital communicating tumors in the past three years. CT and MRI examinations were applied in all cases. Of 16 patients were treated by surgical approaches, Of 6 patients were for radiation therapy. Of 22 cases, 2 cases were osteoid osteoma, 3 cases were meningioma, 1 case was aneurysmal bone cyst, 2 cases were mucous cyst, 2 cases were schwannoma, 2 cases were adenoid cystic carcinoma of lacrimal gland, 2 cases were metastatic carcinoma, and 2 cases were rhabdomyosarcoma. Other 6 cases were treated by radiotherapy without pathological diagnosis. 8 cases for orbital operation including excision of orbital contents 1/8, anterior orbitotomy 3/8, and lateral orbitotomy 4/8, and 8 cases for transcranial operation including frontotemporal orbital roof approach 3/8 and pterion approach 5/8. After operation, the vision acuity of 3 cases was improved, of 10 cases was unchanged and of 3 cases was decreased. Two patients died of metastasis. Among 8 cases of transcranial operation, the complaints such as eye movement disorder, proptosis and conjunctival edema emerged in 1 case. However, among 8 cases of orbital operation, such above complaints were respectively found in 7, 5 and 6 cases. CT and MRI have the great value for diagnosis of cranio-orbital communicating tumors, especially combined with enhanced contrast MRI. Resection of cranio-orbital communicating tumors via the transcranial surgical approach is the effective surgical approach for cranio-orbital communicating tumors.

The expression of MMP-2 and MMP-9 in adenoid cystic carcinoma of lacrimal gland

To investigate the expression of matrix metal proteinase (MMP)-2 and MMP-9 in adenoid cystic carcinoma of lacrimal gland as well as their relation with biological behaviour of adenoid cystic carcinoma. Experimental study. The research objects were 60 cases of adenoid cystic carcinoma of lacrimal gland which were collected from No.2 Hospital of Tianjin Medical University from January 1991 to Jule 2011. There were 25 males and 35 females aged from 29 to 42 years. Based on histological revision, there were 36 cases of cribriform-tubular subtype and 24 cases of solid subtype. Forty-five cases were primary lesions and 15 cases were recurrent lesions. Ten samples of normal lacrimal gland around polymorphic adenoma were selected as the control group. The expression of CD105, MMP-2 and MMP-9 were evaluated by immunohistochemistry. The microvessel density (MVD) was defined by expression of CD105. One way ANOVA, χ(2)-test and spearman correlation test were used to analyzed the data. The number of MVD [(17.71 ± 5.63)/100 folds field of vision] and the positive rates of MMP-2 (45.0%, 27/60) and MMP-9 (55.0%, 33/60) in the samples of adenoid cystic carcinoma of lacrimal gland were higher than those in the normal lacrimal gland [the number of MVD was (0.70 ± 0.95)/100 folds field of vision, the expressions of MMP-2 and MMP-9 were negative] (t' = 2.039, P < 0.05; χ(2) = 5.550, P < 0.05; χ(2) = 8.315, P < 0.01), the solid subtypes had more MVD [(26.12 ± 5.32)/100 folds field of vision] and higher positive rates of MMP-2 (62.5%, 15/24) and MMP-9 (79.2%, 19/24) than the cribriform-tubular subtypes (t' = 2.060, P < 0.05; χ(2) = 4.950, P < 0.05; χ(2) = 9.439, P < 0.05); the recurrent lesions had more MVD and higher positive rate of MMP-2 and MMP-9 than the primary lesions (t' = 2.129, P < 0.05; χ(2) = 9.899, P < 0.05; χ(2) = 8.103, P < 0.05). The number of MVD in ACC of lacrimal gland patients was correlated with the positive rate of MMP-2 and MMP-9 respectively (rs = 0.636, P < 0.05; rs = 0.524, P < 0.05). The number of MVD and the expression of MMP-2 and MMP-9 are higher level in adenoid cystic carcinoma of lacrimal gland and are significantly correlated with pathological type and recurrence. Detecting the number of MVD and the expression of MMP-2 and MMP-9 may become biological indexes for malignancy, recurrence and metastasis of adenoid cystic carcinoma of lacrimal gland.

Influence of Ginkgo biloba extract on the proliferation, apoptosis of ACC-2 cell and Survivin gene expression in adenoid cystic carcinoma of lacrimal gland

ObjectiveTo explore the influence of extract of Ginkgo biloba (EGB) on the proliferation, apoptosis of ACC-2 cell and Survivin gene expression in adenoid cystic carcinoma (ACC) of lacrimal gland. MethodsACC-2 cell in human with ACC of lacrimal gland was in vitro cultured. MTT method was used for cell proliferation detection. Annexin V/PI double-staining flow cytometer was used to detect cell apoptosis and cell cycle. Survivin gene expression was analyzed by RT-PCR and Western blotting. ResultsEGB had inhibitory effect on the proliferation of ACC-2 cell with significant dose-effect relationship, and there was statistical difference when compared with the control group (P<0.01). The inhibitory concentration 50 % (IC50) is 88 mg/L. The flow cytometer test indicated that EGB can gradually increase ACC-2 cell in G0-G1 stage and decrease it in G2-M and S stage. With the increase of dose, the apoptosis rate of ACC-2 cell was obviously increased (P<0.05 or P<0.01). EGB had certain inhibitory effect on Survivin gene expression of ACC-2 cell, and Survivin gene expression was decreased with the increasing of the EGB concentration (P<0.01). ConclusionsEGB can effectively inhibit Survivin gene expression of ACC-2 cell in human with ACC of lacrimal gland, induce the apoptosis of ACC-2 cell and inhibit tumor cell proliferation.

Expressions of E-cadherin and β-catenin in pleomorphic adenoma and adenoid cystic carcinoma of lacrimal gland

目的 研究E-cadherin及β-catenin在泪腺多形性腺瘤和腺样囊性癌中的表达.方法 选取经病理检查确诊为泪腺多形性腺瘤的患者11例11眼和腺样囊性癌的患者6例6眼,分别行E-cadherin和β-catenin免疫组织化学染色.选取泪腺脱垂患者的泪腺组织6例作为正常对照组.结果 正常泪腺组织中E-cadherin呈强阳性表达,主要位于细胞膜;而在泪腺多形性腺瘤中E-cadherin呈弱阳性表达,主要位于细胞质.E-cadherin在腺样囊性癌中未见表达.3组中E-cadherin阳性表达的样本数差异有统计学意义(H=16.492,P=0.000);正常泪腺组E-cadherin阳性表达的样本数明显高于多形性腺瘤组和腺样囊性癌组,差异均有统计学意义(U=-3.561,P=0.000;U=-3.108,P=0.002),多形性腺瘤组中E-cadherin阳性表达的样本数明显高于腺样囊性癌组,差异有统计学意义(U=-2.147,P=0.032).正常泪腺β-catenin细胞膜呈中度或强阳性表达,多形性腺瘤和腺样囊性癌中β-catenin的表达较正常泪腺组织表达阳性程度差异无统计学意义(P＞0.05),腺样囊性癌组中β-catenin细胞核阳性的比例(33.3%,2/6)较多形性腺瘤组(72.7%,7/11)低.结论 E-cadherin表达的下降是参与泪腺上皮性肿瘤发生及癌变的重要因素,而E-cadherin的进一步下降甚至缺失,以及β-catenin的核转位可能是参与泪腺多形性腺瘤恶性转化的因素之一。

Social Challenges of Cancer Patients With Orbitofacial Disfigurement

Patients who undergo orbital exenteration often experience social problems because of their facial disfigurement. The authors studied the interaction of cancer patients who had undergone orbital exenteration with family members and friends (primary groups) and with acquaintances and strangers (secondary groups) in small and large groups. In-depth telephone interviews were conducted with 12 patients treated at a cancer center (7 men and 5 women aged 51-81 years) and 12 family members (8 spouses and 4 children or siblings). Three patients had adenoid cystic carcinoma of lacrimal gland, 3 had squamous cell carcinoma of conjunctiva/eyelid, and 1 each had conjunctival melanoma, eyelid sebaceous gland carcinoma, transitional cell carcinoma of lacrimal sac, adenocarcinoma of orbit, neuroendocrine carcinoma of orbit, and basal cell carcinoma of eyelid. Time from orbital exenteration to interview ranged from 8 months to 36 years (median, 44 months). Two patient groups were identified according to comfort in interactions with acquaintances and strangers. Always comfortable patients were always at ease. Occasionally comfortable patients were at ease in large groups in situations of "benign neglect" and in small groups when they received "sympathy"; were uncomfortable in large and small groups when episodes of "intrusion" occurred; and had mixed responses to benign neglect in small groups and sympathy in large groups. Both patient groups felt comfortable with family members and friends. Patients who will undergo orbital exenteration should be warned about possible difficulties with social interactions. Healthcare personnel should be trained to help patients and family members prepare for such difficulties.

Protein expression of p53, bcl-2, and bax in adenoid cystic carcinoma of lacrimal gland

To investigate the expression of p53, bcl-2, and hax, apoptosis regulating genes, in adenoid cystic carcinoma of larcrimal gland and the roles thereof in clinical prognosis. 56 patients of adenoid cystic carcinoma of larcrimal gland were divided into two groups according to the prognosis: poor prognosis group with recurrence or metastasis within 5 years (n=32) and better prognosis group (n=24) surviving tumor free within 5 years. The protein expression levels of p53, tumor suppressor gene, bax, apoptosis promoting gene, and bcl-2, anti-apoptosis gene, were analyzed by strepavidin peroxidase method. 8 cases of normal lacrimal gland tissues were used as controls. (1) The overall positive rate of p53 of the patients with adenoid cystic carcinoma of larcrimal gland was 73.2%, significantly higher than that of the normal controls (0, P < 0.05). The p53 positive rate of better prognosis group was 62.5%, significantly higher than that of the poor prognosis group (81.3%, P < 0.05). The protein expression of p53 in adenoid cystic carcinoma of larcrimal gland was negatively correlated with clinical prognosis. (2) The overall expression rate of bcl-2 of the patients with adenoid cystic carcinoma of larcrimal gland was 69.6%, significantly lower than that of the control group (P < 0.05). The expression bcl-2 protein was correlated with better clinical prognosis. (3) The bax positive rate of the patients with adenoid cystic carcinoma of larcrimal gland group was 60.7%, not significantly lower than the control group. The bar positive rate of the better prognosis group was 91.7%, significantly higher than that of the poor prognosis group (65.6%, P < 0.05). Some apoptosis regulating genes, such as mutation-type (mt) p53 play an important role in the gene ration and development of adenoid cystic carcinoma of larcrimal gland. p53, bax, and bcl-2 proteins may act as valuable signals for clinical prognosis. The patients with over expression of bcl-2 and bax and low expression of p53 may have better prognosis than the contrary ones.

Retrobulbar Soft Tissue Tumor-Three Cases Report

Retrobulbar soft tissue tumor is rarely managed by plastic surgeons. It may present with disturbance of visual acuity, and progressive proptosis. From February 1991 to June 2000, we treated three cases of retrobulbar soft tissue tumor including: (1) cavernous hemangioma; (2) mixed tumor of lacrimal gland; and (3) adenoid cystic carcinoma of lacrimal gland. Pre-operative diagnostic methods included detailed ophthalmologic examination, coronary CT scan of orbit, and tissue biopsy. Benign tumor was removed through bicoronal incision, which allowed complete degloving of the orbital content, and removal of the tumor under direct vision. No optic nerve injury or limitation of extraocular muscle was found after operation. Malignant tumor was removed with exenteration of orbit. The resultant defect was resurfaced with free radial forearm flap, which provided adequate soft tissue volume and maintained the orbital socket 9 months after radiotherapy and chemotherapy.