Primary Adenoid Cystic Carcinoma Of Lung Research Articles

A series of patients with unusual lung cancers with unusual presentations

Lung malignancies have become increasingly prevalent. Occasionally, an unusual tumour is diagnosed, or a common tumour type presents unusually. This case report reviews 3 cases of thoracic neoplasm, including two cases of uncommon cancers (primary lung adenoid cystic carcinoma and thoracic desmoplastic small round cell high-grade sarcoma) and an atypical presentation of malignant mesothelioma.

The clinicopathological features and curative effect of the bronchoscopic interventional therapy combined with radiotherapy for the treatment of locally recurrent lung adenoid cystic carcinoma

Objective: To explore the clinical value of endoscopic interventional therapy for locally recurrent primary lung adenoid cystic carcinoma (ACC). Methods: The clinical data of 42 patients with locally recurrent ACC were retrospectively analyzed, and the differences of tracheal and bronchial diameter, airway scoring grade and airway obstruction degree before and after treatment were compared among three treatment methods: bronchoscopic interventional therapy + palliative radiotherapy, interventional therapy alone, and non-interventional therapy. Log rank test and Cox proportional risk model multi-factor analysis were used to determine the prognostic factors of ACC patients with local recurrence, and the long-term effect of bronchoscopic interventional therapy on ACC with local recurrence was determined. Results: The median overall survival of 42 patients was 59 months and 5-year survival rate was 54.2%.Univariate analysis showed that vascularized cancer, pleural invasion, pulmonary atelectasis, incisal margin, microscopic classification, tumor diameter, initial TNM stage, ki-67 index, and treatment after local recurrence were associated with long-term survival of ACC patients with local recurrence (all P<0.05). Cox multivariate regression analysis showed that margin status (RR=0.272, P=0.011), tumor diameter (RR=2.586, P=0.005), initial TNM staging (RR=0.369, P=0.035), ki-67 index (RR=3.569, P<0.001), and treatment methods after local recurrence (RR=0.126, P<0.001) were independent factors influencing the prognosis of ACC patients with local recurrence. After three months of treatment, the tracheal bronchus diameters, rating of shortness of breath, and degree of airway obstruction were all improved significantly (all P<0.05), both in the interventional therapy + palliative radiotherapy group [(14.5±2.8 mm, 0.86±0.45, (14.50±10.67)%, respectively], and the interventional therapy alone group [(13.7±2.3) mm, 0.97±0.25, (15.38±12.02)%, respectively]. Meanwhile, the difference before and after non-interventional therapy was not statistically significant (all P>0.05). 5-year overall survival rates were 55.8%, 46.6% and 42.6% for patients undergoing interventional therapy+ palliative radiotherapy, interventional therapy alone, and non-interventional therapy after recurrence, with statistically significant differences (P=0.015). Patients underwent bronchial endoscopic interventional therapy and palliative radiotherapy had the best efficacy of treatment. Conclusion: Endoscopic interventional therapy plus palliative radiotherapy is an effective local palliative treatment for locally recurrent ACC patients, which can rapidly relieve airway stenosis, improve the quality of life of patients and prolong the survival time of patients.

Metachronous adenoid cystic carcinoma in the peripheral lung and at base of the tongue.

Primary lung adenoid cystic carcinoma (ACC) is extremely rare and accounts for approximately 0.1%-0.2% of all lung cancers. ACC of the head and neck has generally been regarded as a slow-growing, low-grade malignancy which has a tendency for local recurrence and frequent distant metastasis. When ACC of the lung is identified, physicians must determine whether it represents distant metastasis or a primary lung cancer. Thyroid transcription factor-1 staining is one of the most useful methods to differentiate primary from metastatic lesions in lung cancer. Herein we report a case of metachronous, not synchronous, ACC at the peripheral lung followed by ACC presentation at the base of the tongue, and review of relevant literatures.

Primary lung adenoid cystic carcinoma: a case report and review of the literature

Adenoid cystic carcinoma (ACC) is a rare low-grade malignant epithelial tumor that usually originates in the salivary glands. It shows a slow progression and metastasizes rarely. A 74-year-old male patient was admitted to our clinic due to pulmonary lesions seen on a chest-X ray coincidentally. The patient, 6 years before admission, was operated on for a peptic ulcer perforation and a right hilar mass lesion, and bibasilar pulmonary nodular lesions were also found on his chest radiograph. A bronchoscopic biopsy revealed ACC and surgical treatment was offered to the patient; however, he refused it. The patient, who had a 130-pack-year smoking history, was asymptomatic on admission to our clinic. Since metastatic pulmonary lesions were present, the patient was diagnosed with stage IV lung cancer and given chemotherapy. Thorax computerized tomography, performed after treatment, revealed no change in the size or number of pulmonary lesions, and the patient has been followed since then and is still asymptomatic. This case of metastatic ACC was reported, after a review of the literature, as being a rare case, as the patient revealed no symptoms from the time of diagnosis until the end of treatment.