• 대한두경부종양학회지
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• 제18권2호
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• pp.157-162
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• 2002

Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

• Radiation Oncology Journal
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• 제17권4호
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• pp.293-298
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• 1999

선양낭포암의 두개내 침습은 매우 드물게 보고되어 있고 구개 선양낭포암이 두개내로 침습된 경우는 국내에서 보고된 바 없다. 침습 기전으로는 직접적인 침습, 신경주위 전이, 혈행성 전이 등 세 가지 경로가 알려져 있다. 본 증례는 35세 여자 환자로 우측 구개 선양낭포암으로 수술과 방사선치료를 받고 3년 10개월 후에 우측 삼차 신경의 안신경가지와 상악 신경가지 부위에 감각이상을 호소하였으나 CT상 재발소견이 보이지 않았다. 이후 우측 안검하수증과 안구마비 증세가 차례대로 발생되어 2차 수술을 받았으며, 종양이 삼차 신경을 따라 두개내 갓세르 반월신경절(Gasserian ganglion)을 거쳐 해면 정맥동과 안와내로 침습됨을 시사했다. 또한 7년 6개월 후에 측두골과 접형골 및 접형동을 통해 우측 측두엽으로 직접 침습된 소견이 발견되어 3차 수술을 받았다. 그 후 폐 전이가 진단된 상태로서, 일차 수술후 9년 5개월동안 생존하여 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.339-342
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• 2009

Adenoid cystic carcinoma(ACC) is the second most common malignant neoplasm in the salivary gland. In spite of ACC shows slowly growing nature, it is sometimes highly detrimental that it readily invades adjacent tissues and metastasize to distant organs at the early stage of disease. Hence, treatment outcome may be misfortunate due to wide regional infiltration, pathognomonic perineural spread and the tendency of hematogenous metastasis. We present a unusal case of ACC of the scalp in which the patient initially presented with bumpy mass of the scalp who had been diagnosed as the primarily developed ACC of the right hard palate that extended to infratemporal fossa, nasal cavity, and paranasal sinuses and had been treated by total excision and post-operative chemotherapy and radiation therapy for 10 years ago. Although this lesion occured at the scalp, which is a frequent site of primary dermatologic ACC, its histomorphology was the same with that of previous tumor. Complete clinical examination showed no recurrence sign at the primary site and suggested the scalp as a sole treatment failure site. Accordingly, it would be reasonable to consider the present case as either a scalp metastasis or a second primary lesion of salivary gland ACC.

• Radiation Oncology Journal
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• 제2권2호
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• pp.191-202
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• 1984

Biological behavior and treatment results of 33 patients with Adenoid Cystic Carcinoma (ACC) in the Head and Neck at Yonsei Cancer Confer for 10 years between 1971 and 1980 were retrospectively analysed. Most common, primary site was minor salivary glands such as maxillary sinus, nasal cavity and base of tongue. The typical biological behavior of these tumors was very slowly in growth with long time of duration(mean 19 months) from 1 month to 10 years and more frequent of nerve invasion but rare invasion of neck nodes. Local control and failure pattern in the results of treatment, 16 of 17 patients with irradiation alone were seen complete or partial response but 5 cases of locoregional recurrence, 2 cases of failure of neck node and 4 cases of distant metastasis as lung and brain. On the other hand, among 10 cases of surgery and postoperative irradiation, 2 cases of locoregional failure and 3 cases of distant metastasis as lung and bone. 2 of 4 cases with surgery alone were recurred within primary site. Actuarial overall NED survival at 3 ana 10 years were $52.6\%$ and $42.8\%$, respectively. Survival rate of 10 Patients with surgery and Postoperative irradiation was more high than 17 Patients of radiation alone. Therefore, we have known that surgery with postoperative adjunctive irradiation is most effective treatment modality of adenoid cystic carcinoma in the head and neck. Primary site, treatment modality and with or without nerve ana bone invasion have influenced on prognosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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• pp.59-70
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• 2008

Purpose: We evaluated the therapeutic effect of AEE788, a dual inhibitor of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) receptor tyrosine kinases on human salivary adenoid cystic carcinoma (ACC) cells growing in nude mice. Experimental Design: We examined the effects of AEE788 on salivary ACC cell growth and apoptosis. To determine the in vivo effects of AEE788, nude mice with orthotopic parotid tumors were randomized to receive oral AEE788 (50 mg/kg) three times per week, injected paclitaxel ($200{\mu}g$) once per week, AEE788 plus paclitaxel, or placebo. Mechanisms of in vivo AEE788 activity were determined by immunohistochemical analysis. Results: Treatment of salivary ACC cells with AEE788 led to growth inhibition and induction of apoptosis. AEE788 inhibited tumor growth and prevented lung metastasis in nude mice. Furthermore, AEE788 potentiated growth inhibition and apoptosis of ACC tumor cells mediated by paclitaxel. Tumors of mice treated with AEE788 and AEE788 plus paclitaxel exhibited down-regulation of activated EGFR and its downstream mediators (Akt and MAPK), increased tumor and endothelial cell apoptosis, and decreased microvessel den-sity, which correlated with a decrease in the level of MMP-9, MMP-2 and bFGF expression and a decrease in the incidence of vascular metastasis. Conclusions: These data show that tumor-associated endothelial cells are important in the process of tumor-metastasis. And VEGFR can be a molecular target for therapy of metastatic lung lesion of salivary ACC.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.30-33
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• 2016

Malignant tumors located in the head and neck areas intermittently show symptoms similar to a temporomandibular disorder (TMD). In our case, a patient who first visited us complaining of TMD-like symptoms, such as trismus and temporomandibular joint (TMJ) pain on the left side, was identified as a sufferer of adenoid cystic carcinoma (ACC) that arose from the left maxillary sinus. The patient may have a TMD symptom, but we are skeptical because the patient also complained of a spontaneously developed numbness on the same side of his upper lip. We observed the panoramic radiograph closely and found the blurred maxillary sinus inferior wall. Dental cone-beam computed tomography confirmed the tentative diagnosis of malignancy on the maxillary sinus. After he had been referred to the Department of Otolaryngology, the diagnosis of the ACC was confirmed. Adequate diagnosis is vital for a quick treatment of the malignancy. There are some keys for differential diagnosis of TMD-like symptoms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권3호
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• pp.177-185
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• 2010

Introduction: Epidermal growth factor receptor (EGFR) is expressed in human epithelial tumors including salivary cancers, and known to be correlated with tumor progression and poor clinical courses in some epithelial tumors. In this study, we determined the therapeutic effect of the anti-EGFR monoclonal antibody Erbitux (C225, cetuximab) in combination with the DNA topoisomerase I inhibitor irinotecan (CPT-11) on human salivary adenoid cystic carcinoma (SACC) cells growing in nude mice. Materials and Methods: At first, immunocytochemical analysis for the expression of EGFR and phosphorylated EGFR (pEGFR) on a human salivary ACC cell line (ACC3). To determine the in vivo effects of Erbitux and CPT-11, nude mice with orthotopic parotid tumors were randomized to receive intraperitoneal Erbitux (1 mg) two times per week, intraperitoneal Irinotecan (50 mg/kg) once per week, Erbitux plus CPT-11, or placebo. (control) Tumor volume and weight were measured. And mechanisms of in vivo activity of Erbitux and/or CPT-11 were determined by immunohistochemical/ immunofluorescent analyses. Results: Immunocytochemical staining of ACC3 demonstrated that EGFR was expressed and phosphorylated. CPT-11 inhibited ACC tumor growth in nude mice. Tumors of mice treated with CPT-11 and CPT-11 plus Erbitux exhibited increased tumor cell apoptosis and decreased microvessel density, which correlated with a decrease in the tumor volume in nude mice. But, CPT-11 seems not to be synergistic with Erbitux in our ACC3 model system. Conclusion: These results suggest that anti-EGFR monoclonal antibody and the DNA topoisomerase I inhibitor will be effective in the treatment of recurred or metastatic lesions of salivary ACC.

• Radiation Oncology Journal
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• 제8권1호
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• pp.35-43
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• 1990

1975년 1월부터 1984년 12월까지 원자력병원 치료 방사선과에서 악성 타액선 종양으로 방사선 치료를 받은 58명의 환자를 대상으로 하여 이들의 생존율을 후향적으로 분석하였다. 이들은 수술후 재발했거나, 수술이 불가능한 환자들이었다. 58명의 환자중 mucoepidermoid carcinoma를 가진 환자가 $43.1\%$, adenoid cystic carcinoma를 가진 환자는 $41.3\%$였다. 주 타액선 종양의 5년 보험생존율은 $68.2\%$, 10년 생존율은 $31.8\%$였으나, 무병생존율은 각각 $43.2\%\;13.0\%$로써 치료 후 재발된 상태에서도 비교적 오래 산다는 것을 알 수 있었다. TNM staging에 의한 생존율도 $T_1$의 5년 생존율이 $86.5\%,\;T_2+T_3$가 $40.0\%,\;T_4$가 $0\%$로, T stage가 높아지면 질수록 생존율도 현저히 감소하였다. 병리조직학적 관점에서 볼 때, adenoid cystic carcinoma의 5년 무병생존율은 $40.1\%$로써, mucoepidermoid ca.의 $49.8\%$보다 낮았으나, 전체적인 생존율은 $77.3\%$로써, mucoepidermoid ca.의 $51.5\%$보다 현저히 높았다. 따라서, adenoid cystic carcinoma는 치료실패후 병을 가진 상태에서도 상당 기간 생존할 수 있다는 것을 알았으며, 평균 생존기간은 2년 이었다. 또한 mucoepidermoid ca.인 경우에는 세포의 분화정도에 따라 생존율이 달라졌는데, 저등도 분화세포의 5년 생존율이 $78.8\%$로 고등도 분화세포의 $38.2\%$보다 거의 2배나 높았다. 암의 위치와 성별에 따른 생존율의 차이는 없었다. Minor salivary gland tumor는 6명으로 5년 보험생존률은 $32.3\%$였다. 따라서 주 타액선 종양의 생존율에 영향을 끼칠 수 있는 예후 인자는 1) 병리조직학적 세포종류, 2) T와 N stages (AJCC), 3) mucoepidermoid carcinoma에 있어서 분화 정도 였다.

• 대한세포병리학회지
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• 제5권2호
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• pp.120-129
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• 1994

Fine needle aspiration biopsy cytology is a widely recognized and useful technique which can provide diagnosis in lesions of the head and neck, enabling appropriate management plans for individual patient to be made. Fifty one fine needle aspirates from salivary gland masses were examined. Four aspirates (8%) were inadequate for examination. Of the remaning 47 samples, 42 cases (82%) were benign lesions which consist of 30 pleomorphic adenoma(58%), 7 inflammatory lesion (14%), 4 Warthin's tumor(8%) and 1 benign lesion(2%). Two cases(4%) were atypical lesions. Three cases(6%) were malignant lesions consisting of 2 adenoid cystic carcinomas(4%) and 1 mucoepidermoid carcinoma (2%). The cytologic diagnoses were compared with the subsequent histologic diagnosis of surgical resected specimen in 24 cases. 19 cases of 21 aspirates from benign tumors were correctly diagnosed by fine needle aspiration cytology, with a specificity of 90%. All 3 aspirates from the 3 patients with malignant tumor were correctly diagnosed by fine needle aspiration cytology, with a sensitivity at 100%. Overall acurracy was 88%. Diagnostic error was encountered in adenoid cystic carcinoma, mucoepidermoid carcinoma and Warthin's tumor Correct histologic diagnosis was made in 86% of benign tumors(84% for pleomorphic adenoma and 100% for Warthin's tumor) and in 100% of malignant tumors.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 1991년도 제8차 학술대회 연제순서 및 초록집
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• pp.18.1-18.1
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• 1991