RESUMEN
Purpose: We assessed whether NICD1 expression, c-MYC expression, and P63 expression by immunohistochemistry (IHC) correlate with prognosis and high-risk clinicopathological features in lacrimal gland adenoid cystic carcinoma (ACC). Methods: Records of patients with lacrimal gland ACC who underwent surgery between 1998 to 2018 were reviewed. Clinicopathologic and treatment data were collected. Tumor tissues were subjected to light microscopy and IHC. Results: Of 43 patients treated during the study period, 21 had archived tumor tissue available and were included. The median age at diagnosis was 47 years, and 13 patients (62%) were male. Thirteen patients (62%) had T2 disease, and none had nodal or distant metastasis at diagnosis. Tumors were positive for NICD1 expression in eight cases (38%), c-MYC expression in eight (38%), and P63 expression in 11 (52%). Positive NICD1 expression was associated with predominantly solid (vs. cribriform/tubular) pattern (P < 0.001), treatment with orbital exenteration (vs. eye-sparing surgery) (P = 0.008), local recurrence (P = 0.047), and death (P = 0.012). Negative P63 expression was associated with predominantly solid pattern (P = 0.001), local recurrence (P = 0.012), distant metastasis (P = 0.001), and death (P = 0.035). A higher percentage of tumor cells staining for c-MYC was associated with presence of perineural invasion (P = 0.036). Positive NICD1 expression was associated with worse disease-free survival (hazard ratio, 6.27; 95% CI, 1.29-30.46), whereas positive P63 expression was associated with better disease-free survival (hazard ratio, 0.03; 95% CI, 0.0002-0.26). Conclusions: IHC for NICD1 and P63 should be considered in lacrimal gland ACC because of their prognostic value and potential as treatment targets.
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Biomarcadores de Tumor , Carcinoma Adenoide Quístico , Neoplasias del Ojo , Enfermedades del Aparato Lagrimal , Proteínas Proto-Oncogénicas c-myc , Receptor Notch1 , Humanos , Carcinoma Adenoide Quístico/metabolismo , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/diagnóstico , Masculino , Persona de Mediana Edad , Femenino , Adulto , Pronóstico , Enfermedades del Aparato Lagrimal/metabolismo , Enfermedades del Aparato Lagrimal/patología , Enfermedades del Aparato Lagrimal/diagnóstico , Anciano , Proteínas Proto-Oncogénicas c-myc/metabolismo , Proteínas Proto-Oncogénicas c-myc/genética , Neoplasias del Ojo/metabolismo , Neoplasias del Ojo/patología , Neoplasias del Ojo/diagnóstico , Estudios Retrospectivos , Biomarcadores de Tumor/metabolismo , Receptor Notch1/metabolismo , Inmunohistoquímica , Adulto Joven , Proteínas de la Membrana , Factores de Transcripción , Proteínas Supresoras de TumorRESUMEN
BACKGROUND: Due to the relative rarity of malignant sublingual gland tumors, diagnosing and treating them clinically pose challenges. Hence, there's a need to explore the pathological types, characteristics, treatment methods, and prognosis of primary malignant tumors of the sublingual gland to improve our understanding and management of these rare yet highly malignant conditions. METHODS: This study reviewed cases of primary malignant sublingual gland tumors, analyzing their characteristics. The treatment methods included surgical excision, with additional radiotherapy, or brachytherapy for advanced stages or positive surgical margins. The study also summarized different treatment approaches, including lymph node dissection and soft tissue reconstruction using free flaps such as the anterolateral thigh flap and forearm flap. RESULTS: We have gathered 23 cases of sublingual gland malignancies treated at the Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, from January 2013 to May 2024. The most common pathological types were adenoid cystic carcinoma and mucoepidermoid carcinoma, with rare cases of mucosa-associated lymphoid tissue (MALT) lymphoma and nonspecific salivary gland clear cell carcinoma. Early diagnosis and surgical intervention were crucial for a favorable prognosis. Marginal mandibulectomy was necessary for cases involving the mandible. Patients with positive preoperative lymph node detection required cervical lymph node dissection. Extensive tissue defects in the floor of the mouth were effectively reconstructed with free flaps to prevent oral-mandibular fistula. CONCLUSION: Surgical excision remains the preferred treatment for malignant sublingual gland tumors. Early diagnosis and comprehensive surgical management are essential for improving prognosis. The study's limitations include a small sample size and short follow-up duration, necessitating further research with larger clinical samples to confirm these findings.
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Neoplasias de la Glándula Sublingual , Humanos , Femenino , Persona de Mediana Edad , Masculino , Neoplasias de la Glándula Sublingual/patología , Neoplasias de la Glándula Sublingual/terapia , Adulto , Anciano , Pronóstico , Adulto Joven , Escisión del Ganglio Linfático , Carcinoma Adenoide Quístico/terapia , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/cirugía , Carcinoma Adenoide Quístico/diagnóstico , Estudios Retrospectivos , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/terapia , Procedimientos de Cirugía Plástica/métodosRESUMEN
RATIONALE: Breast adenoid cystic carcinoma is an extremely rare tumor that is incompletely understood, accounting for less than <0.1% of all breast cancers, with an average diameter of 3 cm, and it is extremely rare to see a large, non-metastatic breast adenoid cystic carcinoma with a diameter of about 30 cm. Since this disease is extremely rare, there are few reports in the literature and limited data on clinical diagnosis and treatment. We present a case of a 71-year-old woman with a large, non-metastatic adenoid cystic carcinoma of the left breast and share our opinion on the diagnosis and treatment of this case. PATIENT CONCERNS: A 71-year-old woman with a 20-year-old left breast mass with local bleeding and rupture for 1 hour presented to our hospital for further diagnosis and treatment. A computed tomography scan showed a large soft tissue mass shadow in the left breast and malignancy was considered. Subsequently, tissue aspiration pathology was performed and the results confirmed adenoid cystic carcinoma of the breast. DIAGNOSIS: Intraoperative pathology results of radical mastectomy for left breast cancer diagnosed adenoid cystic carcinoma of the breast and immunohistochemistry results of triple-negative breast cancer. INTERVENTIONS AND OUTCOMES: Treatment of adenoid cystic carcinoma of the breast included neoadjuvant chemotherapy for breast cancer, radical mastectomy of the left breast, and postoperative chemotherapy. Initially, neoadjuvant chemotherapy for breast cancer was performed, and the TAC regimen was used to successfully reduce the size of the tumor and gain access to surgical treatment for breast cancer. The patient has recovered well after the surgery, with no wound infection or ulceration, and is now waiting for the patient's physical function to recover for postoperative chemotherapy, with no obvious discomfort. LESSONS: Adenoid cystic carcinoma tumors are usually around 3 cm; such a huge 30 cm adenoid cystic carcinoma of the breast is extremely rare, and it is extremely rare to find a breast malignancy that has not developed regional lymph node and distant metastases for more than 20 years. Clinicians must remain vigilant for early breast malignancies at a high age of incidence and conduct further research for diagnosis to avoid delays.
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Neoplasias de la Mama , Carcinoma Adenoide Quístico , Humanos , Carcinoma Adenoide Quístico/cirugía , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/terapia , Femenino , Anciano , Neoplasias de la Mama/patología , Neoplasias de la Mama/diagnósticoRESUMEN
IMPORTANCE: Recurrent/metastatic adenoid cystic carcinoma (R/M AdCC) presents a clinical challenge with limited treatment options, particularly in the face of unsatisfactory efficacy from current therapeutic approaches. This review underscores the unmet clinical needs in managing R/M AdCC, emphasising the imperative for novel therapeutic strategies to address this critical gap. OBJECTIVE: The primary objective of this review is to comprehensively analyse and assess trials investigating therapeutic approaches for R/M AdCC. Emphasis is placed on endpoints such as tumour response rates and progression-free survival. The specific interventions, populations, and outcomes examined in these trials will be detailed to provide a focused and informative systematic review. EVIDENCE REVIEW: The systematic search spanned databases, including PubMed, EMBASE, and the Cochrane database of systematic reviews. Employing terms like "Carcinoma, Adenoid Cystic" and "trial," the search focused on English full-text articles from April 1, 2010, to August 9, 2023. Inclusion criteria encompassed studies with patients having R/M AdCC, involving drug interventions. Study quality was assessed using the Newcastle-Ottawa Scale for retrospective studies, Cochrane ROBINS-I tool for non-randomised trials, and the ROB-2 tool for randomised controlled trials. FINDINGS: A total of 46 trials involving 1244 patients are included in this review, encompassing a variety of therapeutic approaches for R/M AdCC. Targeted therapies, particularly Apatinib at 500 mg, exhibit efficacy with a 47.1% objective response rate (ORR). Conversely, immunotherapeutic agents demonstrate suboptimal performance, with an overall ORR ranging from 0 to 18%. While Apatinib shows promise, the review underscores the imperative for a thorough exploration of drugs targeting unique mechanisms in the immunologically cold nature of R/M AdCC. CONCLUSIONS AND RELEVANCE: Substantial progress in systemic therapy for R/M AdCC is evident, driven by early-phase clinical trials, particularly with promising outcomes in VEGF-2 inhibitors. However, challenges persist, notably in immunotherapy due to the cancer's immunologically cold nature. Ongoing research, prioritising early-stage trials, is crucial, emphasising exploration of emerging therapies like cell therapy and antibody-drug conjugates. Transitioning to Phase III trials is essential for more precise therapeutic insights. Collaborative efforts and a focus on personalised precision medicine are vital for overcoming challenges and advancing our understanding of treatment efficacy in this rare cancer.
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Carcinoma Adenoide Quístico , Recurrencia Local de Neoplasia , Neoplasias de las Glándulas Salivales , Humanos , Carcinoma Adenoide Quístico/tratamiento farmacológico , Carcinoma Adenoide Quístico/patología , Neoplasias de las Glándulas Salivales/tratamiento farmacológico , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/terapia , Recurrencia Local de Neoplasia/tratamiento farmacológico , Metástasis de la Neoplasia , Piridinas/uso terapéuticoAsunto(s)
Anemia , Afasia , Neoplasias de la Mama , Femenino , Humanos , Persona de Mediana Edad , Anemia/diagnóstico , Anemia/etiología , Anemia/terapia , Afasia/diagnóstico , Afasia/etiología , Afasia/terapia , Biopsia , Mama/diagnóstico por imagen , Mama/patología , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Carcinoma Adenoide Quístico/complicaciones , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/terapia , Diagnóstico Diferencial , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
Adenoid cystic carcinoma (AdCC) is a salivary gland neoplasm that infrequently appears in the sinonasal region. The aim of this study was to evaluate the outcome and clinicopathological parameters of sinonasal AdCC. A retrospective analysis was conducted on all cases of AdCC affecting the nasal cavity or paranasal sinuses between 2000 and 2018 at the University Hospital Zurich. Tumor material was examined for morphological features and analyzed for molecular alterations. A total of 14 patients were included. Mean age at presentation was 57.7 years. Sequencing revealed MYB::NFIB gene fusion in 11/12 analyzable cases. Poor prognostic factors were solid variant (p < 0.001), histopathological high-grade transformation (p < 0.001), and tumor involvement of the sphenoid sinus (p = 0.02). The median recurrence-free survival (RFS) and OS were 5.2 years and 11.3 years. The RFS rates at 1-, 5-, and 10-year were 100%, 53.8%, and 23.1%. The OS rates at 1-, 5-, and 10- years were 100%, 91.7%, and 62.9%, respectively. In Conclusion, the solid variant (solid portion > 30%), high-grade transformation, and sphenoid sinus involvement are negative prognostic factors for sinonasal AdCC. A high prevalence of MYB::NFIB gene fusion may help to correctly classify diagnostically challenging (e.g. metatypical) cases.
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Carcinoma Adenoide Quístico , Neoplasias de los Senos Paranasales , Humanos , Carcinoma Adenoide Quístico/genética , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/mortalidad , Carcinoma Adenoide Quístico/epidemiología , Persona de Mediana Edad , Masculino , Femenino , Anciano , Estudios Retrospectivos , Adulto , Neoplasias de los Senos Paranasales/patología , Neoplasias de los Senos Paranasales/genética , Neoplasias de los Senos Paranasales/epidemiología , Pronóstico , Factores de Transcripción NFI/genética , Proteínas de Fusión Oncogénica/genética , Proteínas Proto-Oncogénicas c-myb/genética , PrevalenciaRESUMEN
BACKGROUND: Primary tracheal carcinoma is an exceptionally rare and life-threatening disease that presents significant diagnostic and therapeutic challenges. Delayed diagnosis due to misinterpretation of airway obstruction symptoms often leads to poorer prognoses for patients. This study aimed to explore the clinical manifestations and multidisciplinary treatment approaches for primary tracheal carcinoma in Bangladesh, with a focus on recent advancements in diagnosis and treatment. METHODS: A retrospective observational study was conducted at Bangladesh Specialized Hospital Limited, involving patients aged over 30 who were diagnosed with tracheal carcinoma and underwent multidisiplinary treatment from July 2018 to June 2019. Data were collected through patient interviews and medical record reviews. Descriptive and inferential statistical analyses were performed to examine demographic characteristics, histological variations, tumor locations, clinical signs and symptoms, treatment approaches, and outcomes. RESULTS: The study illuminated varied clinical presentations and the successful application of multidisciplinary approaches among the 13 patients. Invasive squamous cell carcinoma and adenoid cystic carcinoma were the predominant histological subtypes. Symptomatology, including dyspnea, cough, and hemoptysis, highlighted the challenge of early detection. Despite the rarity and intricacies associated with primary tracheal carcinoma, the multidisciplinary strategy yielded generally positive outcomes, as evidenced by a 1-year survival rate of 92.31% and a 5-year survival rate of 76.92%. Kaplan-Meier survival curves underscored the superior efficacy of surgical interventions over non-surgical approaches. CONCLUSION: Despite some limitations, this study contributes crucial insights into the nuanced management of primary tracheal carcinoma in the Bangladeshi context. The demonstrated success of the multidisciplinary strategy, especially surgical interventions, accentuates the importance of definitive resection. The lone case of local recurrence emphasizes the necessity for vigilant follow-up.
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Neoplasias de la Tráquea , Humanos , Neoplasias de la Tráquea/terapia , Neoplasias de la Tráquea/diagnóstico , Neoplasias de la Tráquea/mortalidad , Neoplasias de la Tráquea/patología , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Bangladesh/epidemiología , Adulto , Anciano , Terapia Combinada , Tasa de Supervivencia , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/mortalidad , Carcinoma Adenoide Quístico/terapia , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/mortalidad , PronósticoRESUMEN
BACKGROUND: Canonical transient receptor potential channels play a crucial role in cancer cell proliferation. While TRPC6 subtype detection in submandibular glands and the relevance of some TRPC channels in this gland have been shown in animal models, its histological detection in human lacrimal and submandibular glands, as well as related tumors, lacks systematic study. Studying TRPC6 in humans could lead to new therapeutic options. This research aimed to immunohistochemically detect TRPC6 in human samples of physiological lacrimal and submandibular glands and of adenoid cystic carcinoma and mucoepidermoid carcinoma. METHODS: Seven fixed body donors and samples of six cancer patients were examined. The ten tissue samples collected from the submandibular and lacrimal glands were then processed into histological slides and stained with hematoxylin-eosin. Tumor samples were provided as sections. TRPC6 presence was determined by immunohistochemistry, which was performed by indirect detection with a primary TRPC6 antibody, a secondary HRP-conjugated antibody and the chromogen diaminobenzidine. RESULTS: Results confirm TRPC6 expression in all ten physiological gland samples: all samples showed a immunohistochemical signal with varying intensity. No significant gender-specific differences could be observed. TRPC6 was detected in four of six submandibular adenoid cystic carcinoma and the mucoepidermoid carcinoma samples, especially in tumor cells' cytoplasma and nuclei. Excretory ducts consistently showed TRPC6. Mucous tubules, their nuclei and the nuclei of adipocytes generally showed no signal while serous acini and their nuclei showed a weak TRPC6 signal. CONCLUSION: The discovery of TRPC6 in glandular tissue indicates a role in salivary gland function and calcium homeostasis is a basis for further research into its significance for tumor development in adenoid cystic carcinoma and mucoepidermoid carcinoma of salivary glands. TRPC6 could be used as a target for treatment of these tumors. However, the correlation between TRPC6 and submandibular and lacrimal gland diseases requires further exploration.
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Carcinoma Adenoide Quístico , Inmunohistoquímica , Aparato Lagrimal , Neoplasias de las Glándulas Salivales , Glándula Submandibular , Canal Catiónico TRPC6 , Humanos , Femenino , Masculino , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/metabolismo , Persona de Mediana Edad , Aparato Lagrimal/patología , Aparato Lagrimal/metabolismo , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/metabolismo , Canal Catiónico TRPC6/metabolismo , Glándula Submandibular/patología , Glándula Submandibular/metabolismo , Anciano , Adulto , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/metabolismo , Biomarcadores de Tumor/metabolismo , Biomarcadores de Tumor/análisisRESUMEN
OBJECTIVE: Limited availability of authentic human adenoid cystic carcinoma (ACC) cell lines has hindered progress in understanding mechanisms underpinning the biology of this disease and the development of safe and effective therapies. STUDY DESIGN: Surgical human ACC specimens (UM-HACC-6, UM-HACC-14) were dissociated into single cell suspensions and cultured in fibronectin-coated flasks. Alternatively, tumor fragments were transplanted subcutaneously into female immunodeficient (SCID) mice to establish patient-derived xenograft tumors (PDX; UM-PDX-HACC-14). RESULTS: Both ACC cell lines showed continuous growth in monolayers for over 100 passages. Total RNA-Seq, RT-PCR, and FISH analysis revealed that both are MYB-NFIB fusion negative. Western blots revealed passage-dependent expression of E-Cadherin, PCNA, p63, phospho-c-MYB, and NFIB. Both, UM-HACC-14 and UM-HACC-6 cells exhibited tumorigenic potential when injected orthotopically into mouse submandibular glands. CONCLUSION: UM-HACC-14, patient-matching UM-PDX-HACC-14, and the UM-HACC-6 cell line are new, authenticated preclinical models of ACC that are well suited for mechanistic and developmental therapeutics studies.
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Carcinoma Adenoide Quístico , Ratones SCID , Neoplasias de las Glándulas Salivales , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/metabolismo , Animales , Humanos , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/metabolismo , Ratones , Femenino , Línea Celular Tumoral , Western Blotting , Xenoinjertos , Hibridación Fluorescente in SituRESUMEN
BACKGROUND: Adenoid cystic carcinoma is a rare subtype of triple-negative breast carcinoma. These low-grade tumours, which are treated by simple mastectomy and have an excellent prognosis compared to other triple-negative breast carcinomas. Solid-variant adenoid cystic carcinomas have basaloid features and are difficult to distinguish morphologically from other triple-negative breast cancers. Breast adenoid cystic carcinoma exhibits MYB protein overexpression, which can be detected by immunohistochemistry (IHC). AIM: We compared the IHC expression of MYB in solid-variant adenoid cystic carcinoma with that in other triple-negative breast cancers. METHODS: We conducted IHC staining of 210 samples of triple-negative breast cancers, including solid-variant adenoid cystic carcinoma (n = 17), metaplastic breast carcinoma (n = 44), basaloid triple-negative breast cancer (n = 21), and other triple-negative invasive ductal carcinoma (n = 128). We classified nuclear staining of MYB as diffuse/strong (3+), focal moderate (2+), focal weak (1+), or none (0). RESULTS: All 17 solid/basaloid adenoid cystic carcinoma cases exhibited 3+ MYB expression. Of the 21 solid/basaloid triple-negative breast cancers, one (5%) had 2+ expression, seven (33%) 1+ expression, and 13 (62%) 0 expression. Of the 44 metaplastic carcinoma cases, 39 cases (89%) had no (0) staining, and the other five cases had focal weak (1+) or moderate (2+) staining. Among the 128 triple-negative invasive ductal carcinoma cases, 92 cases (72%) had no (0) staining, 36 cases (28%) exhibited focal weak (1+) or moderate (2+) staining. CONCLUSIONS: Our study revealed diffuse/strong MYB staining (3+) only in solid/basaloid adenoid cystic carcinomas. Thus, we recommend routine MYB IHC staining in triple-negative breast carcinoma with solid/basaloid morphology to improve diagnostic accuracy.
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Biomarcadores de Tumor , Carcinoma Adenoide Quístico , Inmunohistoquímica , Proteínas Proto-Oncogénicas c-myb , Neoplasias de la Mama Triple Negativas , Humanos , Carcinoma Adenoide Quístico/metabolismo , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/patología , Neoplasias de la Mama Triple Negativas/patología , Neoplasias de la Mama Triple Negativas/metabolismo , Neoplasias de la Mama Triple Negativas/diagnóstico , Femenino , Proteínas Proto-Oncogénicas c-myb/metabolismo , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/metabolismo , Persona de Mediana Edad , Anciano , Adulto , Sensibilidad y Especificidad , Anciano de 80 o más AñosAsunto(s)
Carcinoma Adenoide Quístico , Resección Endoscópica de la Mucosa , Neoplasias Esofágicas , Humanos , Carcinoma Adenoide Quístico/cirugía , Carcinoma Adenoide Quístico/patología , Resección Endoscópica de la Mucosa/métodos , Neoplasias Esofágicas/cirugía , Neoplasias Esofágicas/patología , Masculino , Persona de Mediana Edad , FemeninoRESUMEN
The adenoid cystic carcinoma (ACC) of Bartholin's gland is a very rare tumor that usually grows aggressively due to perineural invasion. Although there is no guideline for the treatment due to the small number of patients, the primary treatment is considered as surgery. Adjuvant radiotherapy has also been shown to be beneficial. Three cases, which were histopathologically confirmed as ACC of Bartholin's gland and received adjuvant radiotherapy treatment, were presented in this study.
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Glándulas Vestibulares Mayores , Carcinoma Adenoide Quístico , Humanos , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/terapia , Glándulas Vestibulares Mayores/patología , Femenino , Persona de Mediana Edad , Adulto , Neoplasias de la Vulva/patología , Radioterapia Adyuvante/métodosAsunto(s)
Infecciones por Papillomavirus , Neoplasias de los Senos Paranasales , Humanos , Femenino , Infecciones por Papillomavirus/virología , Neoplasias de los Senos Paranasales/virología , Neoplasias de los Senos Paranasales/patología , Neoplasias de los Senos Paranasales/genética , Anciano de 80 o más Años , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/virología , Inhibidor p16 de la Quinasa Dependiente de Ciclina/metabolismo , Papillomaviridae/genética , Factores de Transcripción SOXERESUMEN
Adenoid cystic carcinoma (ACC) is a rare tumour of the salivary glands characterised by distant metastases, mainly to lungs and bone. Isolated metastasis to the liver is unusual. We present the case of a woman with an ACC of the submandibular gland (pT1N0) who underwent radical submandibular gland excision and selective neck dissection. Preoperative imaging identified a liver lesion with features suggestive of a haemangioma. Two-year postoperatively, a surveillance CT neck/trunk showed an increase in size of the left liver lobe lesion. Subsequent MR liver and US-guided biopsy confirmed the lesion to be metastatic ACC. The patient underwent a successful left lateral liver sectionectomy. She remains disease-free 2.5 years after her liver resection. A literature search revealed only four other similar cases. This report highlights that even early-stage ACCs of the salivary gland may present with synchronous solitary liver metastasis which can be effectively treated with curative surgery.
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Carcinoma Adenoide Quístico , Neoplasias Hepáticas , Neoplasias de la Glándula Submandibular , Humanos , Carcinoma Adenoide Quístico/secundario , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/cirugía , Carcinoma Adenoide Quístico/diagnóstico por imagen , Femenino , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias de la Glándula Submandibular/patología , Neoplasias de la Glándula Submandibular/secundario , Neoplasias de la Glándula Submandibular/cirugía , Tomografía Computarizada por Rayos X , Persona de Mediana Edad , Glándula Submandibular/patología , Glándula Submandibular/cirugía , Hepatectomía , Imagen por Resonancia Magnética , Disección del CuelloAsunto(s)
Carcinoma Adenoide Quístico , Neoplasias de la Tráquea , Humanos , Carcinoma Adenoide Quístico/cirugía , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/diagnóstico por imagen , Carcinoma Adenoide Quístico/radioterapia , Tomografía Computarizada por Rayos X , Neoplasias de la Tráquea/diagnóstico por imagen , Neoplasias de la Tráquea/cirugía , Neoplasias de la Tráquea/patologíaAsunto(s)
Carcinoma Adenoide Quístico , Neoplasias de la Tráquea , Humanos , Carcinoma Adenoide Quístico/radioterapia , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/diagnóstico por imagen , Neoplasias de la Tráquea/diagnóstico por imagen , Neoplasias de la Tráquea/patología , Masculino , Persona de Mediana Edad , Femenino , Tomografía Computarizada por Rayos XAsunto(s)
Carcinoma Adenoide Quístico , Neoplasias de la Tráquea , Humanos , Carcinoma Adenoide Quístico/radioterapia , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/diagnóstico por imagen , Neoplasias de la Tráquea/diagnóstico por imagen , Neoplasias de la Tráquea/patología , Neoplasias de la Tráquea/radioterapia , Tratamientos Conservadores del Órgano/métodos , Masculino , FemeninoRESUMEN
Adenoid cystic carcinoma (ACC) is a rare, usually slow-growing yet aggressive head and neck malignancy. Despite its clinical significance, our understanding of the cellular evolution and microenvironment in ACC remains limited. We investigated the intratumoral microbiomes of 50 ACC tumor tissues and 33 adjacent normal tissues using 16S rRNA gene sequencing. This allowed us to characterize the bacterial communities within the ACC and explore potential associations between the bacterial community structure, patient clinical characteristics, and tumor molecular features obtained through RNA sequencing. The bacterial composition in the ACC was significantly different from that in adjacent normal salivary tissue, and the ACC exhibited diverse levels of species richness. We identified two main microbial subtypes within the ACC: oral-like and gut-like. Oral-like microbiomes, characterized by increased diversity and abundance of Neisseria, Leptotrichia, Actinomyces, Streptococcus, Rothia, and Veillonella (commonly found in healthy oral cavities), were associated with a less aggressive ACC-II molecular subtype and improved patient outcomes. Notably, we identified the same oral genera in oral cancer and head and neck squamous cell carcinomas. In both cancers, they were part of shared oral communities associated with a more diverse microbiome, less aggressive tumor phenotype, and better survival that reveal the genera as potential pancancer biomarkers for favorable microbiomes in ACC and other head and neck cancers. Conversely, gut-like intratumoral microbiomes, which feature low diversity and colonization by gut mucus layer-degrading species, such as Bacteroides, Akkermansia, Blautia, Bifidobacterium, and Enterococcus, were associated with poorer outcomes. Elevated levels of Bacteroides thetaiotaomicron were independently associated with significantly worse survival and positively correlated with tumor cell biosynthesis of glycan-based cell membrane components.