Cystic Carcinoma Of Salivary Origin Research Articles

Liver metastasis of adenoid cystic carcinoma of salivary origin: report of a case prepared by ThinPrep method

Liver metastasis of adenoid cystic carcinoma of salivary origin: report of a case prepared by ThinPrep method

Distant metastasis in adenoid cystic carcinoma of salivary origin

Adenoid cystic carcinoma (ACC) is an aggressive, often indolent tumor, with a high incidence of distant metastasis (DM). Relatively little has been written about the factors that influence distant spread and subsequent survival because it is uncommon and more than a decade of observation may be required to appreciate the prolonged clinical course in some patients. We have retrospectively studied 196 determinate patients who received definitive treatment in our hospital between 1939 and 1986 for ACC in all salivary sites. Inclusion criteria were no prior treatment elsewhere other than excisional biopsy and eligibility for follow-up of at least 10 years. Variables assessed for their impact on distant metastasis included age, gender, site, size, node status, stage, grade, and locoregional treatment failure. Treatment failure occurred in a total of 122 of 196 determinate patients (62%), 74 of whom had DM (38%). This was usually associated with locoregional recurrence (51 patients), but DM was the only indication of failure in 23 whose primary tumor was controlled. Of the 74 patients with known DM, the lung was recorded as the only involved site in 50 patients, lung was involved in addition to other sites in 17, bone metastases alone occured in 5, and the remaining 2 developed disseminated disease. Disease-free intervals varied from 1 month to 19 years (median 36 months) and exceeded 10 years in 9 of 113 patients (8%) with adequate information about treatment failure. Survival with DM was less than 3 years in 54%, but more than 10 yrs in 10% (maximum 16 years). The only significant factors influencing survival were the size of the primary tumor (P <0.0000), local or neck recurrence (P = 0.0006), and the presence of nodal involvement (P = 0.02). The high incidence of DM with locoregional failure confirms the importance of aggressive initial surgery, combined with irradiation, for high-stage tumors or involved surgical margins. Large tumor size and lymph node involvement, rather than microscopic appearance, were predictive of DM. Considering that lung metastases are usually multiple, and prolonged survival without treatment is not unusual, resection of pulmonary metastases may be hard to justify in ACC patients based on the limited experience thus far reported. Chemotherapy for metastatic ACC is probably best withheld until symptoms appear.

Metastasis to the Choroid Complicating Adenoid Cystic Carcinoma

Two months after a complete response to doxorubicin hydrochloride and cyclophosphamide administered for systemic effects, with the disappearance of pulmonary and pleural metastases from adenoid cystic carcinoma of salivary origin, a patient experienced symptomatic choroidal metastasis with no other evidence of active disease. Irradiation produced complete disappearance of the choroidal metastasis and restoration of visual acuity. The literature is reviewed, and the unusual nature of this metastasis is discussed.

Adenoid cystic carcinoma: Factors influencing survival

We have reviewed our experience with 264 patients treated for adenoid cystic carcinoma of salivary origin. This study updates a previous report from our hospital and includes all patients treated during a 30 year period who were eligible for a minimum follow-up of 10 years. The tumor arose in minor salivary (mucous) glands in two thirds of the patients; half had received treatment elsewhere, and both sexes were equally represented. Actuarial survival curves and "cure" rates calculated by the direct method confirm that clinical staging provides a reliable prognostic guide. We are unable to demonstrate that the microscopic appearance of the tumor exerts a predictable effect on treatment results. Although some patients lived for many years after resection despite local recurrence and distant metastases, prolonged survival was unusual in patients with stage 3 lesions, particularly in those with sinus or submaxillary gland primaries. Based on the site of origin of the tumor and its clinical stage, it is now possible to select which patients with adenoid cystic carcinoma have the most ominous prognosis and perhaps plan a more appropriate operation. More importantly, these data may help focus on the subpopulation at greatest risk, which is vital to the design of any prospective study to assess the value of adjunctive irradiation and chemotherapy.

Adenoid cystic carcinoma of salivary origin: A clinicopathologic study of 242 cases

In recent years, the term “adenoid cystic carcinoma” has won increasing acceptance as the one preferred for the unusual, malignant epithelial tumor that Billroth called “cylindroma” in 1856 [I-7]. Whatever the preference in nomenclature, neoplasms showing an adenoid cystic histologic pattern are quite uncommon and may arise in a variety of anatomic sites, including the paired salivary glands, the lacrimal gland [8,9], the mucous glands of the upper respiratory [IO] and digestive tracts [11,12], the skin [13,14], and the breast [15,16]. In this study, we shall focus on a sizable experience with adenoid cystic carcinoma arising in major and minor salivary (mucous) glands. Patients having similar tumors in the lacrimal glands or mucous glands of the trachea have been excluded, although other reports suggest that the clinical course is similar [8,10]. The designation of certain rare skin and breast tumors as “adenoid cystic” is somewhat misleading, inasmuch as the clinical course in such patients is quite different.