• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.23-28
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• 2018

Background/Objectives: Adenoid cystic carcinoma is the second most common salivary carcinoma. It occurs commonly in the submandibular gland, sublingual gland and minor salivary gland. Local recurrence and distant metastasis are the leading cause of death. The aim of this study was to evaluate long-term oncologic outcomes of patients with head and neck adenoid cystic carcinoma focusing on distant metastasis. Materials & Methods: We retrospectively studied 39 patients who were diagnosed with and treated for adenoid cystic carcinoma of the head and neck from December 1996 to May 2018. The clinicopathologic characteristics of patients such as age, sex, primary site and TNM stage, and treatment methods, recurrence and distant metastasis after treatment, survival rate, and treatment method for recurrence were analyzed. Results: Of 39 patients, 18 were males and 21 were females, and the mean age was $5.9{\pm}14.4$ (28-89) years. The most common primary site was oral cavity (12 cases), and followed by sino-nasal cavity (11 cases), parotid gland (5 cases), and etc. For treatment, 17 patients underwent surgery alone, 16 received surgery with postoperative radiation therapy, and 3 patients received radiation therapy only. Three patients refused any further treatments. Recurrence occurred in 15 patients. The most common site of recurrence was the lung. The mean time to recurrence was 31.7 months. The 5 and 10 years' overall survival rate was 79.3% and 74%, respectively. The 2 and 5 years' overall survival rate was 69.6% and 62.6% in patients with distant metastasis. Conclusion: Distant metastasis is an important prognostic factor in adenoid cystic carcinoma, and eventually one third of patients have distant metastasis, especially in the lung. An appropriate treatment for lung metastasis is necessary because some patients with pulmonary metastasis survive for a quite long time.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.579-583
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• 1994

A 22-year old female visited CNUH due to palpable neck mass. Cytologic examination of a fine needle aspiration was performed and the result was Pap class II. Routine chest x-ray shows solitary pulmonary nodule. For rule-out malignancy, FNA at neck mass was repeated and pathologic finding was dysplasia. She was admitted to MI department for evaluation of solitary pulmonary nodule and percutaneous needle aspiration was done. Pathologic diagnosis was adenoid cystic carcinoma. Thereafter, the lesions were treated by excisional biopsy of submandibular gland mass with left supraomohyoid neck dissection and wedge resection of right lower lobe at ENT department and thoracic and cardiovascular surgery department, respectively. Final diagnosis was adenoid cystic carcinoma arising in submandibular gland with solitary lung metastasis. According to TMN staging system, surgical staging is stage IV of T2N0M1. Clinical follow-up to postoperative 13 months in this case showed that she is alive and well without evidence of recurrence.

• Korean Journal of Head & Neck Oncology
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• v.8 no.2
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• pp.63-71
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• 1992

After analysis according to age, sex, site of origin, nodal involvement, perineural invasion. histopathology and treatment modality. authors had reached the following conclusion about the 28 cases of adenoid cystic carcinoma of the salivary gland, which were, histopathologically, diagnosed at Yonsei University Severance Hospital and Yongdong, Severance Hospital during the 8-year period from Apr. 1983 to Mar. 1991. Among the 28 cases, 13 were females and 15 were males, which implies that there isn't any sigificant distinction of gender. The age range was 24 years to 69 years with a mean age of 49 years, and the most common site of origin in order was 6 cases(21.4%) of maxillary sinus, 5 cases(17.8%) of submandibular gland, each 4 cases(14.4%) of parotid gland, palate, 3 cases(10.4%) of nasal cavity and each 2 cases(7.1%) of mouth floor, nasopharynx with each one case(3.6%) of buccal mucosa and retromolar trigone. With clinical staging by UICC, the 5-year survival of adenoid cystic carcinoma was 100% in stage I and II, 87.5% in stage III. In stage IV, all of the patient were died within 3 years. We have known that the prognosis was poorer in following cases; the cases with higher clinical stage, primary site other than the major salivary gland especially maxillary sinus and positive neural or nodal invasion.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.153-160
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• 1983

Adenoid cystic carcinoma is a rare primary tracheal tumor and this tumor behave slow growth, low-grade ma!ignancy, locally invasion and long-term host survival. Operation with the primary goal of complete excision is the treatment of choice but this tumor require excessive margins at surgical removal because of locally invasive cancer. A 45-years-old male patient had complained paroxysmal coughing from 1 year ago prior to admission and was diagnosed pre-operatively as endotracheal adenoma. He had been treated by operation, and combined with radiotherapy by 4 MeV. Lineal Accelerator. The tracheal mass was removed by tracheo-bronchotomy transpleurally and right total pneumonectomy was performed. There was post-operative course uneventfully and no post-operative complication. The patient Is free from cancer until post-operative 1 year clinically and alive with good healthy.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.158-163
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• 2003

Objectives: To document the incidence and pattern of c-kit protein expression & mutation in adenoid cystic carcinomas. Materials and Methods: Twenty-five cases of adenoid cystic carcinomas of the major and minor salivary glands and the upper and lower respiratory tract were subjected to the immunohistochemical study for ckit(CD117 ; Dako). Nineteen cases of them were analyzed for mutations in exon 11 and exon 17 by PCR-SSCP, and in cases of need, by DNA sequencing. Results: Twenty-three cases (92%) showed c-kit expression, but none showed mutations in exon 11 and exon 17. The expression was restricted to the inner luminal cells in all tubular types and most of cribriform adenoid cystic carcinomas, while the staining was diffuse in all solid variants and two cribriform types. Conclusion: C-kit expression was common in adenoid cystic carcinomas, regardless of their origins. Although genetic bases await further studies, a clinical trial of tyrosine kinase inhibitors in adenoid cystic carcinomas, especially in solid variants, is considered encouraging.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.2
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• pp.375-385
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• 1992

This is a report of adenoid cystic carcinoma occurred in the palate in 30-year-old patient with a complaint of exophytic mass. The authors diagnosed it as adenoid cystic carcinoma by the clinical examination, radiographic findings and histopathological findings. The obtained results are as follows: 1. In clinical examination, asymptomatic exophytic mass of palate was observed. 2. In radiographic findings, soft tissue mass infiltrated the left maxillary sinus, nasal cavity, infraorbital fossa, hard palate, pterygopalatine fossa and pterygoid plate, and enhanced soft tissue mass was also observed in CT. 3. In histopathological findings, tubular and solid patterns of glandular structures were observed and the infiltration of tumor cells into the nerve fibers was also observed. 4. Two years after radical surgery, radiation therapy and chemotherapy, the perineural spread to orbital area was observed. 5. Much longer follow-up than 5 years is needed for early diagnosis of recurrence and distant metastasis.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.273-276
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• 2008

Although adenoid cystic carcinoma (ACC) of the lacrimal gland is a rarely encountered orbital tumor, it invades intracranially more frequently than carcinomas of other glands in the head and neck. A 52-year-old man underwent orbital exenteration and resection of intracranially extended tumor via a fronto-orbito-zygomatic approach in combination with a transfacial approach. Histopathologically, the tumor showed perineural, vascular, and lymphatic invasion. Additionally, he received radiotherapy (60 Gy) and adjuvant systemic cisplatin and 5-fluorouracil chemotherapy due to residual tumor in the orbit and systemic metastases (lung, ribs, and spines). He was free of progression and recurrence at 6 months after treatment. The authors report a case of skull base invasion by an ACC of the lacrimal gland to remind neurosurgeons planning intervention that this disease shows a tendency to invade intracranially.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.110-122
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• 2005

Adenoid cystic carcinoma (ACC) of salivary glands has a protracted clinical course with perineural invasion, delayed onset of hematogenous metastasis, and poor responses to classical cytotoxic chemotherapic agents. Most deaths from salivary ACC are caused by lung metastases that are resistant to conventional therapy. Therefore, knowledge of cellular properties and tumor-host interactions that influence the dissemination of metastatic cells is important for the design of more effective therapy of salivary cancer. I determined in vitro expression of epidermal growth factor receptor (EGFR) and its downstream effectors and vascular endothelial growth factor receptor (VEGFR)-2 on a human salivary ACC cell line (ACC2). I also evaluated the expression of EGF and VEGF signaling molecules and metastasis-related proteins on human salivary ACC cells orthotopically growing in nude mice. In Western blot and immunohistochemical analyses, EGFR and VEGFR-2 were presented and phosphorylated in ACC2 cells. In human parotid cancer xenografts in nude mice, EGF and VEGF signaling molecules, IL-8, and MMP-9 were expressed at markedly higher levels than in normal parotid tissues. Moreover, tumor-associated endothelial cells of this orthotopic parotid tumor expressed phosphorylated VEGFR-2 and phosphorylated Akt, which is a cell-survival protein. These data show that those biomarkers can be molecular targets for therapy of salivary ACC, which has a propensity for delayed lung metastasis.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.217-223
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• 1996

A retrospective analysis was performed to assess the relationship between the treatment modalities and treatment results in patients with adenoid cystic carcinoma of the maxillary sinus. From Feb. 1977 to March 1994, 10 patients with the disease were treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine. Six men and 4 women were presented with median age of 57 years. According to AJCC TNM system, all patients except one had advanced T3 and T4 disease. Only one patient had the regional metastasis to lymph node but none of them had hematogenous metastasis on initial admission. One patient(Group 1) was treated with surgery alone, 3 patients(Group 2) were treated with definitive radiotherapy and 6 patients(Group 3) were treated with combination of surgery and radiotherapy. One patient who was treated with surgery alone had experienced a locoregional recurrence 9 months later and 3 patients who were treated with radiation therapy alone had PRs(partial response) followed by the subsequent progression of the local disease. Whereas all patients who were treated with combination of surgery and radiation therapy had CRs(complete response). Among them, only one patient was recurred in the primary site, who was salvaged by reoperation and reirradiation therapy. In conclusion, combination of surgery and radiotherapy resulted in the best treatment modality for adenoid cystic carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced adenoid cystic carcinoma of the maxillary sinus.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.137-147
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• 1997

The rarity of primary tumor of the trachea, which was recently estimated in a circumscribed population to be 2.7 new cases per million per year, explains the relatively limited experience that has been acquired even by major institutions. Although there may already by a high degree of airway obstruction, tracheal tumors are usually misdiagnosed as bronchial asthma or chronic bronchitis because of its nonspecific symptoms. Surgery is the treatment of choice. Recently, the authors experienced three cases of primary tracheal malignant tumors ; one case of mucoepidermoid carcinoma and two cases of adenoid cystic carcinoma. The authors report on these cases with a review of the literature for give help in differential diagnosis and treatment planing of tracheal tumor.