Laryngeal Adenoid Cystic Carcinoma Research Articles

174 Modern Radiotherapy in the Treatment of Laryngeal Adenoid Cystic Carcinoma, a systematic review.

174 Modern Radiotherapy in the Treatment of Laryngeal Adenoid Cystic Carcinoma, a systematic review.

The Impact of the COVID-19 Pandemic on the Prognosis of Laryngeal Adenoid Cystic Carcinoma: A Case Report and a Literature Review

Laryngeal adenoid cystic carcinoma (LACC) is a sporadic neoplasm, especially if supraglottic. The COVID-19 pandemic worsened the presenting stage of many cancers and impacted their prognosis negatively. Here, a case of a patient with adenoid cystic carcinoma (ACC) with delayed diagnosis and a rapid deterioration with distant metastasis due to the COVID-19 pandemic is illustrated. Next, we present a literature review of this rare glottic ACC. The COVID-19 pandemic worsened the stage of presentation of many cancers and adversely affected their prognosis. The present case had a rapidly lethal course, undoubtedly due to the diagnosis delay caused by the COVID-19 pandemic, which impacted the prognosis of this rare glottic ACC. Strict follow-up is recommended for any suspicious clinical findings, as an early diagnosis will improve the disease prognosis, and to consider the influence of the COVID-19 pandemic, especially on the timing of common diagnostic and therapeutic procedures for oncological diseases. In the post-COVID-19 era, it is important to generate new diagnostic scenarios to achieve an increasingly rapid diagnosis of oncological diseases, especially the rare ones, through screening or similar procedures.

WITHDRAWN: Comparative immunohistochemical analysis of CD34 and PCNA expression in salivary and laryngeal adenoid cystic carcinoma

WITHDRAWN: Comparative immunohistochemical analysis of CD34 and PCNA expression in salivary and laryngeal adenoid cystic carcinoma

Immunohistochemical analysis of CD34 and PCNA expression in salivary and laryngeal adenoid cystic carcinoma

Background/purpose: Adenoid cystic carcinomas (ACC) are malignant tumors that affect major and minor salivary glands. LACC is an extremely rare location for this type of tumour. This study describes the immunohistochemical analysis of CD34 and PCNA expression in salivary and laryngeal ACC. Materials and methods: The study included 40 formalin-fixed paraffin-embedded blocks were used, 20 of them were previously diagnosed as SACC, and 20 as LACC. All sections were stained with hematoxylin and eosin (H&E) and immunohistochemical marker to detect CD34 and PCNA protein. Results: Regarding the expression of CD34, SACC had recorded the highest mean area % (31.58), while LACC recorded the lowest mean area % (14.25) and the comparison revealed that there was a highly significant difference between these lesions where P value was (<0.001) concerning the expression of PCNA, SACC had recorded the highest mean area % (36.28), while LACC recorded the lowest mean area % (20.7) and the comparison revealed that there was a highly significant difference between these lesions where P value was (<0.001). Conclusions: immunohisto­chemical analyses presented here indicated that LACC tends to nonaggressive oncological behavior and angiogenesis when compared to SACC.

Adenoid Cystic Carcinoma of the Larynx: A SEER Database Review.

Adenoid cystic carcinoma (AdCC) of the larynx is an uncommon malignancy of the head and neck with very little literature discussing treatment paradigms and prognostic factors influencing survival. This retrospective cohort study uses data obtained from the Surveillance, Epidemiology and End Result database comprising of patients diagnosed with laryngeal AdCC from 1978 to 2016. A total of 89 records were analyzed. High histologic grade was a significant negative prognostic factor compared to low histologic grade disease for overall survival (OS; 5-year OS: 35.7% vs 90.5%, P < .005) and disease-specific survival (DSS; 5-year DSS: 38.7% vs 95.2%, P < .005). No differences in OS (5-year OS: 88.9% vs 76.4%, P = .287) or DSS (5-year DSS: 100% vs 79.1%, P = .159) were noted between patients with early versus late American Joint Committee on Cancer (AJCC) stage disease. No differences in DSS was noted in cohorts treated with just definitive surgery versus surgery and adjuvant radiation (5-year DSS: 92.9% vs 74.3%, P = .140) even when stratified for late stage disease (5-year DSS: 100% vs 78.6%, P = .290) or high-grade histology (5-year DSS: 100% vs 83.3%, P = .773). Histologic grade may be a more significant prognostic factor than AJCC stage for survival in laryngeal AdCC. Treatment with surgery and radiation may provide no additional survival advantage compared to just definitive surgery in these patients, although further study is warranted.

Laryngeal Adenoid Cystic Carcinoma: A rare neoplasm with still undefined treatment aspects. Case report and literature review

Adenoid Cystic Carcinoma (ACC) is a rare malignant tumor, accounting for about 1% of head and neck malignancies and 10% of salivary gland cancers. The laryngeal localization of ACC is particularly rare because of the paucity of accessory salivary glands in this anatomical district. Prevalence is highest in the fifth and sixth decade of life with a slight female predilection and aetiology is unknown. Since laryngeal ACC characteristically grows slowly and occurs in the subglottis, the diagnosis, which is based on the combination of physical examination with fiberoscopy and neck-chest Computerized Tomography (CT), is often delayed. Nowadays the debate is still open about which is the best comprehensive therapy of this tumor. We present the case of a laryngeal ACC in a 68 year-old-woman, treated with total laryngectomy together with bilateral neck dissection and a literature review made with the purpose to point out the most recent advancements towards the definition of a gold-standard therapy. Laryngectomy results as the first choice treatment, while chemotherapy has minimal effects on this neoplasm and radiotherapy alone does not show the capacity to lead to complete resolution, but there is still the need of further studies to clarify the usefulness and the role played by neck dissection and postoperative radiotherapy.

The role of organ- and function-preserving radiotherapy in the treatment of adenoid cystic carcinoma of the larynx.

To evaluate clinical outcome and functional larynx preservation after radiotherapy (RT) for adenoid cystic carcinoma (ACC) of the larynx. Eleven patients with primary ACC of the larynx, who received RT definitely (n = 5/11) or postoperatively (n = 6/11), were analyzed regarding survival and treatment-related toxicity with the focus on functional larynx preservation. Median follow-up was 45 months. RT offered an excellent 5-year local control (LC) rate of 100%. Eight of 11 patients were treated with a laryngeal preservation approach (LPA). At last follow-up, only one of these eight patients developed a local recurrence requiring a total laryngectomy 11 years after treatment. Severe toxicity was uncommon, with only one patient with LPA, requiring a temporary tracheostomy during therapy. RT is an effective treatment method for laryngeal ACC with excellent LC rates, preservation of the laryngeal function and voice formation, representing a valuable therapy alternative to total laryngectomy.

Accelerated Hypofractionated Active Raster-Scanned Carbon Ion Radiotherapy (CIRT) for Laryngeal Malignancies: Feasibility and Safety.

(1) Background: The authors present the first results of active raster-scanned carbon ion radiotherapy (CIRT) for radioresistant laryngeal malignancies regarding efficacy and toxicity. (2) Methods: 15 patients with laryngeal adenoid cystic carcinoma (ACC; n = 8; 53.3%) or chondrosarcoma (CS; n = 7; 46.7%) who underwent radiotherapy with carbon ions (C12) at the Heidelberg Ion Beam Therapy Center (HIT) between 2013 and 2018 were identified retrospectively and analyzed for local control (LC), overall survival (OS), and distant progression-free survival using the Kaplan–Meier method. CIRT was applied either alone (n = 7, 46.7%) or in combination with intensity modulated radiotherapy (IMRT) (n = 8, 53.3%). The toxicity was assessed according to the Common Toxicity Terminology Criteria for Adverse Events (CTCAE) v4.03. (3). Results: the median follow-up was 24 months (range 5–61 months). Overall, the therapy was tolerated very well. No grade >3 acute and chronic toxicity could be identified. The most reported acute grade 3 side effects were acute dysphagia (n = 2; 13%) and acute odynophagia (n = 3; 20%), making supportive nutrition via gastric tube (n = 2; 13.3%) and via high caloric drinks (n = 1; 6.7%) necessary due to swallowing problems (n = 4; 27%). Overall, chronic grade 3 toxicity in the form of chronic hoarseness occurred in 7% of the patients (n = 1; 7%). At the last follow-up, all the patients were alive. No local or locoregional recurrence could be identified. Only one patient with laryngeal ACC developed lung metastases three years after the first diagnosis. (4) Conclusions: the accelerated hypofractionated active raster-scanned carbon ion radiotherapy for radioresistant laryngeal malignancies is feasible in practice with excellent local control rates and moderate acute and late toxicity. Further follow-ups are necessary to evaluate the long-term clinical outcome.

Adenoid cystic carcinoma of the larynx in a 70-year-old patient: A case report.

Adenoid cystic carcinoma (ACC) is a relatively rare tumor that accounts for <1% of all head and neck malignancies. Laryngeal localization of ACC, which is most commonly hypoglottic, is relatively rare, occurring in 0.07–0.25% of all laryngeal tumors. ACC is characterized as a slow-growing tumor with a high recurrence rate, which often causes dyspnea and hoarseness. ACC exhibits a propensity for perineural invasion and thus, patients may experience pain as a late symptom of the disease. Distant metastasis occurs in 35–50% of cases and the lungs are the most common site of metastasis. Tumors are usually diagnosed by physical examination with fiberoscopy and computed tomography of the neck and chest, due to the high rate of lung metastases. The standard therapy for ACC is surgery followed by radiotherapy. In this study, a 70-year-old patient presented with laryngeal ACC, who underwent total laryngectomy with bilateral neck dissection and adjuvant radiotherapy, is presented. Follow-up examination performed 2 years after surgery revealed no evidence of locoregional recurrence or distant metastases. Previously published literature regarding ACC of the larynx was also reviewed.

The Case Report of Laryngeal Adenoid Cystic Carcinoma: A Rare Entity

Introduction: Laryngeal adenoid cystic carcinoma (LACC) is a very rare cancer among laryngopharyngeal malignancies with varieties in presentation. Case Presentation: Here, we discuss a case of 54-year-old female who was admitted in the emergency department with long-term dyspnea, hoarseness, and stridor. Cervicothoracic multi detector computed tomography (MDCT) scan showed a mass in the laryngeal area and the pathology reported adenoid cystic carcinoma in the biopsy. Total laryngectomy and partial pharyngectomy was taken into action. The adjuvant radiotherapy was performed too. Conclusions: Although adenoid cystic carcinoma is rare, it is advised to use both CT-scan and deep biopsy to make definite diagnosis. Surgical excision is necessary and follow up is advised, although surgical excision of this tumor is extremely challenging case by case.

Adenoid cystic carcinoma of the larynx presenting with unusual subglottic mass: Case report

A 33-year-old woman presented with an unusual subglottic bulging mass accompanied by prolonged cough and wheeze. Laryngeal endoscopy revealed a bilateral, symmetrical mass immediately below the vocal cords with marked airway obstruction. Chronic subglottic laryngitis with inflammation or another condition such as amyloidosis was initially suspected. Cervicothoracic computed tomography revealed an obvious reduction of laryngeal caliber caused by an engulfing mass extending from just under the vocal cords to the cricoid ring, which was associated with thyroid, arytenoid, and cricoid cartilage destruction. Histopathological diagnosis of a biopsy specimen collected via a tracheotomy revealed that the lesion was a cT4aN0M0 adenoid cystic carcinoma (ACC) originating from the laryngeal minor salivary glands. The patient was treated by total laryngectomy with elective bilateral neck dissection under general anesthesia. Gross inspection of resected tissue confirmed yellowish-white, solid tumor mainly circumferentially encompassing the lumina of the cricoid ring. The histopathological findings confirmed typical ACC accompanied by a predominant cribriform appearance with no evidence of lymph node metastasis. The patient remains well and free of recurrence or metastasis. We herein describe laryngeal ACC and discuss radiological images and the surgical pathology.

Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents <1% of all laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome. PubMed, Web of Science, MEDLINE, and EMBASE databases. A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome. A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively. LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up.

Adenoid cystic carcinoma of the larynx: A report of two cases.

Laryngeal adenoid cystic carcinoma (ACC) is extremely rare, worldwide. From January 1994 to January 2014, all cases of laryngeal ACC that were diagnosed in the four largest hospitals in Hainan province, were reviewed. Only two such cases were identified. The first patient had a tumor in the subglottic region and the second patient, in the glottic region. The patient with subglottic ACC, who had experienced ongoing symptoms for 3 years, had previously been diagnosed with asthma, at a local hospital. Both presented at an advanced stage. The patient with subglottic disease received a total laryngectomy with a positive surgical margin, was treated with adjuvant radiotherapy, and later succumbed to a pleural effusion as a result of pulmonary metastases. The patient with glottic disease received a partial laryngectomy and declined adjuvant radiotherapy. Subsequently, she developed recurrent disease and passed away following an episode of asphyxia at 14 months post-surgery. Each of these cases had a poor prognosis at presentation. For patients with locoregionally advanced laryngeal ACC, more effective management strategies are required.

Adenoid cystic carcinoma of the larynx: a report of six cases with review of the literature

Conclusion: Adenoid cystic carcinoma (ACC) in the larynx is an extremely rare entity. Although the 5-year disease-specific survival rates for laryngeal ACC are high, distant metastasis might occur up to more than 5 years post treatment. Therefore patients with ACC require long-term follow-up. Objective: To summarize the characteristics of laryngeal ACC by analyzing six cases in a single center. Methods: This was a retrospective analysis of six patients with laryngeal ACC who were treated in Beijing Tongren Hospital between 1998 and 2013. Results: The mean age at diagnosis was 44 years, ranging from 15 to 61 years. Dyspnea was the most common complaint. All patients underwent combined-modality treatment with surgical resection and external beam radiation. The range of follow-up time varied from 1 to 7 years (median 5 years). Follow-up inspections indicated that none of them had local or regional recurrence. Distant metastasis occurred in 33.7% (2/6) of the patients, with one lung metastasis 5 years after operation and one liver metastasis 4 years after operation.

Organ Preservation for Adenoid Cystic Carcinoma of the Larynx

Two cases of adenoid cystic carcinoma (ACC) of the larynx were treated with chemoradiotherapy (CRT) for organ preservation. We reviewed case series and current literature to contrast the potential role of primary CRT as an organ-sparing modality with standard laryngectomy and radiotherapy in patients with laryngeal ACC. Two treatment-naïve patients with laryngeal ACC treated at Dana-Farber Cancer Institute between 2002 and 2007 were identified. Both patients were offered standard laryngectomy followed by adjuvant radiotherapy or organ-sparing treatment modality. Both patients were males, aged 57 and 73. The patients completed a course of combined chemoradiotherapy with weekly carboplatin and paclitaxel and 7-8 weeks of radiotherapy to a total dose of 6,600 and 7,000 cGy over 50 and 57 days, respectively. There were no treatment breaks or delays because of toxicity. The major toxicities reported by both patients, as anticipated, were Grade 3 mucositis, desquamative dermatitis, and severe dysphagia, all of which resolved. Both patients are alive with local regional control and functional larynx; one at 112+ months with pulmonary metastases at 54 months, and the other disease free at 60+ months. Definitive chemoradiation with weekly carboplatin and paclitaxel may be a potential alternative to the current standard of surgery and radiation for patients with locally advanced laryngeal ACC who request an organ-sparing approach. In this group of patients, salvage laryngectomy may be reserved for those who are locally recurrent or chemoradiotherapy resistant. Although CRT provided long-term local regional control in our two patients, there are evident limitations in obtaining evidence for a determination of treatment of rare diseases. This report provides support for following an organ preservation plan in selected patients.

Adenoid cystic carcinoma of the airway: a 30-year review at one institution

PurposeThe purpose of the study was to evaluate the treatment results of adenoid cystic carcinoma (ACC) of the airway at a single institution during a 30-year period. Materials and methodsAll cases of ACC of the airway over a 30-year period at one tertiary care institution were reviewed retrospectively. The demographics, treatment modalities, pathologic characteristics, and outcomes were evaluated. ResultsEleven patients were treated for ACC of the airway with an age range of 25 to 72 years (median, 48 years). Six patients presented with ACC in the larynx, and 5 patients had ACC of the trachea. All patients underwent surgical excision and radiation; 9 of 11 patients had postoperative external beam radiation, 1 patient had preoperative external beam radiation, and the remaining patient had postoperative neutron beam therapy. Four patients with tracheal ACC and none with laryngeal ACC had microscopic or grossly positive margins after surgery (P = .048). Eighty percent of patients had perineural invasion on pathology. Two patients with tracheal ACC had local recurrence of disease, which occurred at 1 and 10 months postoperatively. One patient with laryngeal ACC died of distant metastatic disease at 16 months. Follow-up varied from 4 to 168 months (median, 31 months). ConclusionsWe report high disease-free survival rates for ACC of the airway in patients who underwent definitive surgical resection followed by postoperative radiation. There is a higher risk for local recurrence and positive surgical margins with distal tracheal location. Distant disease ultimately determines survival.

Carcinome adenoide kystique sous-glottique

Introduction: Laryngeal adenoid cystic carcinoma (ACC) is unusual. It accounts for 0.25% of all malignant tumors in the larynx, and only about 120 cases have been reported in the literature until now.Purpose: We report a case of subglottic ACC and examine the clinical, diagnostic, histological and therapeutic features and the outcome of this tumor in this location.Case report: A 75-year-old man, presented with a laryngeal dyspnea. The computed tomography of the larynx showed a posterior subglottic tumor. The panendoscopy revealed a large nonulcerated submucosal tumor in the posterior wall of the subglottic area. Biopsies made the diagnosis of laryngeal ACC. The patient had total laryngectomy with total thyroidectomyand bilateral lateral neck dissection. Histological examination didn't find neck metastases. The surgery was followed by a postoperative radiotherapy. There were no local recurrence or distant metastases during one year and half of follow-up.Conclusions: ACC shows a very slow growth pattern. Its diagnosis is often delayed and its treatment is based on surgery and postoperative radiotherapy. This tumor is characterized by the occurrence of local recurrence and distant metastases often several years after treatment of the primary tumor.Keywords: adenoid cystic carcinoma, subglottic, surgery, postoperative radiotherapy, survival.

A report of laryngeal adenocystic carcinoma metastatic to the spleen and the role of splenectomy in the management of metastatic disease: a case report

IntroductionAdenoid cystic carcinoma (ACC) of the larynx is a rare malignancy characterized by an indolent course and late pulmonary metastases. Metastases from the larynx to the spleen are an unusual event. In the present report, we discuss a patient with adenoid cystic carcinoma of the larynx metastatic to the spleen. A review of the literature did not yield any other such incidents. We review the clinical presentation and course of adenoid cystic carcinoma, as well as the role of splenectomy for metastases.Case presentationWe present a case of laryngeal adenoid cystic carcinoma in a 26-year-old Caucasian man treated with total laryngectomy and ionizing radiation. He initially developed asynchronous pulmonary metastases, which were resected. Our patient subsequently presented with a symptomatic splenic lesion consistent with metastatic disease, for which he underwent laparoscopic splenectomy.ConclusionsSplenectomy might be indicated for isolated metastases. A splenectomy effectively addresses symptoms and serves as a cytoreduction modality.

喉頭腺様嚢胞癌例

Laryngeal adenoid cystic carcinoma is rare disease. We report herein on a case of adenoid cystic carcinoma arising in the subglottic region of the larynx. A 52-year-old female presented with a 2-month history of progressive dyspnea during exercise. Endoscopic examination of the larynx revealed a submucosal mass lesion in the subglottic area. An excisional biopsy was performed using the laryngofissure technique. The pathological diagnosis was cribriform type adenoid cystic carcinoma. The patient underwent total laryngectomy with bilateral neck dissection (Level 2-4) and postoperative radiation therapy. She has been alive without locoregional recurrence and distant metastasis for 18 months. We discuss herein the clinical and pathological features of adenoid cystic carcinoma of the larynx as well as reviews of the reported cases in the literature. Up to the present, only 22 cases including our case have been reported in Japan. For the patients with adenoid cystic carcinoma of the larynx, long-term follow-up is essential because of the possibility of delayed recurrence or metastases.

Adenoid cystic carcinoma of the larynx: A 40‐year experience

Laryngeal adenoid cystic carcinoma (ACC) is a rare disease. We reviewed our experience at the Princess Margaret Hospital (PMH) with its treatment. This is a retrospective chart review of 15 cases treated at PMH between 1963 and 2005. The mean age was 48.6 years. There was no sex predilection. The subglottis was the most common subsite involved. Only 2 patients had regional metastasis. Local or regional recurrence was noted in 5 patients (33.3%). The distant metastasis rate was 66.7% and involved the lungs. The median follow-up time was 6.9 years. The 5- and 10-year overall and disease-specific survival rates were 64% and 46%, and 69% and 49%, respectively. Laryngeal ACC is a rare disease with a high rate of distant recurrence. Its management should emphasize maximizing local and regional disease control by surgery followed by radiotherapy with distant disease failure eventually dictating survival.