Adenoid Cystic Carcinoma Of Maxillary Sinus Research Articles

Comparison of 5-year survival rate and analysis of prognostic factors influencing the prognosis of adenoid cystic carcinoma and squamous cell carcinoma of the maxillary sinus: based on the SEER database

Objective:To analyze the difference in 5-year survival between maxillary sinus adenoidal cystic carcinoma（maxillary sinus adenoid cystic carcinoma, MSACC） and squamous cell carcinoma（maxillary sinus squamous cell carcinoma, MSSCC） using the National Cancer Institute's Surveillance, Epidemiology, and End. Results:database（SEER） and to explore the factors associated with the prognosis of the two tumors. Methods:The data of 161 patients with MSACC and 929 patients with MSSCC were collected from SEER database, and the 5-year overall survival rate（OS） and tumor specific survival rate（CSS） were compared between the two groups before and after propensity score matching. The forest map of multivariate Cox proportional hazard regression model was established to analyze the prognostic factors affecting the survival rate of patients with MSACC and MSSCC. Results:There were statistical differences in 5-year OS and CSS between MSACC and MSSCC before and after propensity score matching（P<0.001）. Multivariate regression analysis showed that age, side of the disease, lymph node metastasis, operation and radiotherapy were the influencing factors of OS in MSACC, while age and operation were the influencing factors of CSS. Age, race, T grade, lymph node metastasis, systemic metastasis, surgery, radiotherapy and chemotherapy are the influencing factors of OS of MSSCC. Age, T grade, lymph node metastasis, systemic metastasis, surgery, radiotherapy and chemotherapy are the influencing factors of CSS. Conclusion:The 5-year survival rate of MSACC is higher than that of MSSCC. Surgery plays a positive role in the prognosis of the two kinds of tumors. The analysis results can provide some reference for their survival expectations and treatment choices.

Metastasis of maxillary sinus adenoid cystic carcinoma to the humerus bone—A rare case report

Adenoid cystic carcinoma accounts for 10 to 12% of all salivary gland malignant neoplasms with an estimated incidence of 3 to 4.5 cases per million per year. Perineural spread and multiple local recurrences are its defining features, although the liver and lung are the most frequent sites for distant metastases. It is extremely uncommon for adenoid cystic carcinoma of the maxillary sinus to spread to distant bones. Few cases of adenoid cystic carcinoma with distant bone metastasis have been reported. Here, we report a known case of the adenoid cystic carcinoma of the maxillary sinus in a 40-yearold male, with isolated metastasis to the left humerus bone presenting 4 years later to the excision of the primary lesion. The fine-needle aspiration cytology, trucut biopsy, and immunocytochemistry of the left humerus osteoexpansile lesion confirmed the diagnosis of metastatic adenoid cystic carcinoma. This rare case report re-emphasizes the distant metastatic potential of adenoid cystic carcinoma.

Computed Tomography and Magnetic Resonance Imaging Findings Contribute to Differentiating Solid- and Nonsolid-Type Adenoid Cystic Carcinoma in Maxillary Sinus.

This study aimed to evaluate the imaging features of maxillary sinus adenoid cystic carcinoma (ACC) on computed tomography (CT) and magnetic resonance imaging (MRI) and to investigate the imaging differences between solid and nonsolid maxillary sinus ACC. We retrospectively reviewed 40 cases of histopathologically confirmed ACC of the maxillary sinus. All the patients underwent CT and MRI. Based on the histopathological characteristics, the patients were classified into 2 groups: ( a ) solid maxillary sinus ACC (n = 16) and ( b ) nonsolid maxillary sinus ACC (n = 24). Imaging features such as tumor size, morphology, internal structure, margin, type of bone destruction, signal intensity, enhancement changes, and perineural tumor spread on CT and MRI, were evaluated. The apparent diffusion coefficient (ADC) was measured. Comparisons of imaging features and ADC values were performed between the solid and nonsolid maxillary sinus ACC using χ 2 and nonparametric tests. The internal structure, margin, type of bone destruction, and degree of enhancement significantly differed between solid and nonsolid maxillary sinus ACC (all P < 0.05). The ADC of the solid maxillary sinus ACC was considerably lower than that of the nonsolid maxillary sinus ( P < 0.05). Computed tomography and MRI may aid in the differentiation of solid and nonsolid types of maxillary sinus ACC.

Metastatic versus metachronous adenoid cystic carcinoma in the lacrimal gland fossa: a case report

A 53-year-old woman presented with a left painless enlarging lacrimal fossa lesion with hypoglobus and choroidal folds. 18 months earlier, she had undergone surgery and chemoradiotherapy for right maxillary sinus adenoid cystic carcinoma. After initial 1.5T magnetic resonance imaging, a double primary of left lacrimal gland adenoid cystic carcinoma with tricompartmental (frontal bone, lacrimal and temporalis fossa) involvement was suspected. However, subsequent high-field multi-parametric 3T magnetic resonance imaging suggested a solitary metastasis with a subperiosteal location and an uninvolved lacrimal gland. The solitary metastasis was confirmed intraoperatively and pathologically.

Numb chin with mandibular pain or masticatory weakness as indicator for systemic malignancy - A case series study.

Numb chin syndrome (NCS) is a critical sign of systemic malignancy; however it remains largely unknown by clinicians and dentists. The aim of this study was to investigate NCS that is more often associated with metastatic cancers than with benign diseases. Sixteen patients with NCS were diagnosed and treated. The oral and radiographic manifestations were assessed. Four (25%) of 16 patients with NCS were affected by nonmalignant diseases (19% by medication-related osteonecrosis of the jaw and 6% by osteopetrosis); yet 12 (75%) patient conditions were caused by malignant metastasis, either in the mandible (62%) or intracranial invasion (13%). NCS was unilateral in 13 cases and bilateral in three cases. Mandibular pain and masticatory weakness often dominate the clinical features in NCS associated with cancer metastasis. In two patients, NCS preceded the discovery of unknown malignancy (breast cancer and leukemia). In nine others, NCS heralded malignancy relapse and progression. Metastatic breast cancer in four (36%) cases accounted for the most common malignancy. Other metastatic diseases included two multiple myelomas, and one each of leukemia, prostate cancer, colon cancer, lung cancer, maxillary sinus adenoid cystic carcinoma and adrenal gland neuroblastoma. Radiographic examinations showed obvious mandibular metastasis with compression of the inferior alveolar nerve or mental nerve in nine patients, and leptomeningeal seeding or intracranial metastasis to the trigeminal nerve root at the skull base in two patients. NCS without obvious odontogenic causes or trauma often signals systemic malignancy. It may be the first clue of occult malignancy.

Adult cancer-related hemophagocytic lymphohistiocytosis \u2013 a challenging diagnosis: a case report

BackgroundAdult hemophagocytic lymphohistiocytosis is a secondary immunopathologic phenomenon, mainly secondary to malignancy, infection, or autoimmune disorders.The performance of diagnostic criteria, studied in the pediatric population, is yet to be validated in the adult population. Some of the criteria include cytopenias and organomegaly that are inherent features to malignant processes, thus making the diagnosis of hemophagocytic lymphohistiocytosis a challenge in patients with cancer.Case presentationWe describe the case of a 54-year-old white man with history of metastatic maxillary sinus adenoid cystic carcinoma who had severe liver injury and cytopenias with progressive clinical deterioration. We performed an evaluation, by flow cytometry, of the expression of surface markers in his natural killer cells that revealed remarkable abnormalities. His syndrome eventually fulfilled criteria for hemophagocytic lymphohistiocytosis and he received therapy with steroids with interval clinical improvement. Unfortunately, he refused further cytotoxic treatment and died 2 weeks later.ConclusionsThe conventional criteria for the diagnosis of hemophagocytic lymphohistiocytosis are suboptimal for adult patients with cancer resulting in delays in diagnosis and timely initiation of treatment. The diagnostic criteria have to be re-evaluated in patients with cancer; novel, easily available, and accurate diagnostic methods are needed.

Adenoid cystic carcinoma of the maxillary sinus: a clinical–pathological report of 10 years of experience from a single institution

Adenoid cystic carcinoma (ACC) is the most common malignant salivary gland tumour of the maxillary sinus. The present study describes 24 cases seen over a period of 10 years at the Brazilian National Cancer Institute. Socio-demographic, clinical, pathological, and follow-up data were retrieved from the medical files for the period 1997–2006. The mean age of the patients was 51.1 years. Twenty-one (87.5%) presented advanced tumours. The main signs and symptoms found were a tumour mass (87.5%), pain (50%), nasal obstruction (25%), and epistaxis (20.8%). Most cases (62.5%) were treated with surgery and radiation therapy. Follow-up data showed two patients (8.3%) with residual disease, local recurrences in four (16.7%) patients, and distant metastasis in five (20.8%). The overall 5- and 10-year survival rates were 72.61% and 62.11%, respectively. Maxillary sinus ACC has an aggressive but indolent behaviour, typically presenting at an advanced T stage that reflects a poor prognosis for patients.

Comment on “Pulmonar collision tumor” and “Well-differentiated fetal adenocarcinoma”

Blanco et al. from Vigo1 and Ouazzani e al. from Rabat2 show how Bronchial-Pulmonary Carcinomas are dealt with nowadays. They discuss the cases of a 38 years old woman with a very rare Well Differentiated Fetal Adenocarcinoma (the unique carcinoma referred with a differentiation grade in the WHO 2004 Classification of lung tumors) and a 56 years old man presenting two metastasis of a right maxillary sinus Adenoid Cystic Carcinoma after a gap of 11 years. These two cases are reviewed in parallel with a Pleomorphic Carcinoma of the lung (WHO 2004 -glandular neoplastic proliferation -Adenocarcinoma -with large cells with severe atypical cytology -with pleomorphic elements), which required immunohistochemistry for correct diagnosis and carcinogenic understanding. It is fortunate that surgical specimens give Modern Pathology an open laboratory so that the consequences of carcinogenic stimulation can be understood -nothing happens by chance -and the prognosis arrived at by a combination of morphology, immunostaining, molecular actual validation and pTNM, under the Pathologist’s supervision. Embryology and adult potential stem cells expressions are now recognised as research tools in the interpretation of the histopathology of all benign and malignant tumors and the two examples under consideration, were obviously

Adenoid cystic carcinoma of maxillary sinus: diagnosis, treatment and prognostic factors

To study the clinical characters, the outcomes of treatments and the factors affecting long-term treatment results of adenoid cystic carcinoma (ACC) of the maxillary sinus. The clinical data of 80 patients with ACC of the maxillary sinus treated initially were analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression. The 5-, 10- and 15-year cumulative overall survival rates were 65.2%, 37.1%, 26.3% respectively and 5-, 10-, and 15-year disease-free survival rates 50.7%, 30.7% and 24.5% respectively. The 5-, 10- and 15-year cumulative local control rates were 68.5%, 47.3% and 47.3% respectively and the cumulative distant metastasis rate were 32.8%, 48.8% and 48.8% respectively. Prognostic factors affecting survival included T stage, pathologic grade and the modes of treatment (P < 0.05). Patients with combined therapy composed of surgery and radiation had a better local control, compared with surgery or radiation alone (χ(2) = 18.33, P < 0.01), and surgery combined with postoperative radiation was prior to preoperative radiation combined with surgery (χ(2) = 6.64, P < 0.05). Patients treated with surgery combined with preoperative radiation, either with doses of ≥ 60 Gy or with negative margins, had a better local control, compared with doses < 60 Gy and with positive margins (χ(2) = 5.06, P < 0.05). The most of patients (62.8%) died of local recurrence. The most of failure was due to recurrence. Combined therapy composed of surgery and radiation improves the local control and survival in patients with ACC of the maxillary sinus, compared with surgery or radiation alone. Surgery combined with postoperative radiation provides the best overall survival and local control and should be the first choice of treatments.

Tumor-to-Tumor Metastasis: Maxillary Sinus Adenoid Cystic Carcinoma Metastasizing to Double Primary Lung Adenocarcinoma

Tumor-to-tumor metastasis is a rare occurrence. The most frequent metastatic donor is lung cancer, and the most frequent recipient is renal cell carcinoma. Here we present a patient in whom lung cancer served as a metastatic recipient and maxillary sinus adenoid cystic carcinoma acted as a metastatic donor. This patient has double primary lung cancer, which increased the complexity of this case.

Fractionated stereotactic radiation therapy for extracranial head and neck tumors

Background: This study is to report the clinical experiences of fractionated stereotactic radiation therapy (FSRT) for extracranial head and neck tumors. Methods and Materials: Between the period of July 1995 and November 1998, 48 patients with extracranial head and neck tumors were given FSRT as a boost and sole modality. Individualized treatment planning was performed using XKnife-3 system with relocatable Gill-Thomas-Cosman frame. In 24 patients, FSRT was applied as a boost technique following the 2-dimensional conventional external radiation therapy (ERT); in 24 patients FSRT was the sole radiotherapy modality. The primary diseases in the boost group consisted of nasopharynx cancer (19), lacrimal gland adenoid cystic carcinoma (3), orbital lymphoma (1), and skull-base recurrence of maxillary sinus adenoid cystic carcinoma (1). The primary diseases in the sole modality group consisted of recurrent nasopharynx cancer (12), orbital pseudotumor (4), skull-base recurrence of maxillary sinus, submandibular gland, and hypopharynx cancers (3), orbital rhabdomyosarcoma (2), orbital lymphoma (1), orbital metastasis of neuroblastoma (1), and nasal cavity melanoma (1). The fractionation schedule was to give 5 treatments per one week and the fractional doses were 2.0–3 Gy depending on the treatment aim and the FSRT volume. The FSRT doses varied depending on the nature of the primary diseases. Results: The local tumor response in nasopharynx cancer patients was excellent compared to retrospective data without occurrence of unexpectedly severe complication. FSRT to other regions was well tolerated by the patients and resulted in good to excellent local tumor responses with no unacceptable side effects as expected by the authors. Conclusion: Based on the current observations, FSRT is a very effective and safe modality in the treatment of extracranial head and neck tumors.