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Primary adenoid cystic carcinoma at base of tongue; hematoxylin and eosin, original magnification x 10.
Source publication
Adenoid cystic carcinoma is a rare neoplasm that originates from secretory glands, most commonly from the salivary glands. We present a 76 year-old white man with a history of adenoid cystic carcinoma from the base of the tongue diagnosed 15 years prior to the development of the metastatic lesion on his mid-posterior scalp. The present case represe...
Contexts in source publication
Context 1
... had a history of non-melanoma skin cancer (NMSC) and right base of tongue ACC with pulmonary metastases. The primary ACC was diagnosed 15 years prior to this visit and the tumor had peri-and intraneural invasion (Figure 2). The initial treatment was surgical excision, followed one month later by a re-excision to obtain negative margins. ...
Context 2
... had a history of non-melanoma skin cancer (NMSC) and right base of tongue ACC with pulmonary metastases. The primary ACC was diagnosed 15 years prior to this visit and the tumor had peri-and intraneural invasion (Figure 2). The initial treatment was surgical excision, followed one month later by a re-excision to obtain negative margins. ...
Similar publications
Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm of the salivary glands. We present a case of a 70-year-old male patient with a swelling over the dorsal and ventral surface of anterior two third of the tongue which was causing him difficulty in mastication since 10 months. Ultrasound and magnetic resonance imaging were done follow...
Citations
... This case highlights the aggressive nature of the tumour with an extremely poor prognosis following cutaneous spread. All 11 cases of salivary gland ACC with cutaneous metastasis reported in the literature were reviewed (Table 1) [10][11][12][13][14][15][16][17][18][19][20] . In all previous cases, cutaneous metastasis has occurred following metastasis to other tissue prior, most commonly to the lung and bone. ...
Adenoid cystic carcinoma (ACC) is an aggressive salivary gland neoplasm characterized by high rates of local recurrence, early metastasis, and a poor long-term prognosis. Approximately 20-50% of cases result in distant metastasis, commonly involving the lung, bone, liver, and brain. Cutaneous metastasis is a rare occurrence, with a small number of cases reported previously in the context of multiple metastatic sites of involvement. We present a unique case of ACC of the hard palate with isolated cutaneous metastasis. A 36-year-old woman underwent a subtotal maxillectomy and skull base resection for the treatment of a T4N0 ACC of the right maxilla. One year postoperatively, the patient presented with multiple rapidly growing painful nodules on the skin of the scalp, neck, and chest. Biopsy confirmed metastatic poorly differentiated ACC, and positron emission tomography demonstrated cutaneous metastatic lesions without evidence of other tissue involvement. This case highlights the possible rare and aggressive pathways of metastasis of ACC. Currently there is no consensus for the treatment of disseminated disease, due to the poor efficacy of current treatment modalities. Where isolated metastasis is present, surgical resection can be attempted to control disease progression; however the benefit of metastasectomy on survival is not substantiated. As such, the role of newer targeted systemic therapies needs to be further investigated in the hope of achieving disease control.
... Other characteristic features of ACC include its slow growth and development of late distant metastasis (DM), sometimes even years after treatment of the primary tumor. These metastases most often occur in the lungs, but can also be seen in bones, brain, liver, scalp, thyroid, spleen, kidneys, omentum and pancreas [12][13][14][15][16]. Due to perineural invasion, DM and an increased recurrence rate, ACC shows poor long-term prognosis [17]. ...
Background:
The objective was to assess demographic and survival patterns in patients with adenoid cystic carcinoma of the base of tongue.
Methods:
Patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1973 through 2012 and were categorized by age, gender, race, historical stage A, and treatment. Incidence and survival were compared with Kaplan Meier curves and mortality hazard ratios.
Results:
A total of 216 patients were included. After adjusting for age, gender, race and tumor-directed treatment, patients over the age of 70years had a significantly increased mortality [HR=2.847, 95% CI (1.499, 5.404) p=0.0014]. Furthermore mortality among patients with distant disease was significantly increased [HR=2.474 95% CI (1.459, 4.195) p=0.00008].
Conclusion:
By examining the largest collection of patients we have demonstrated that there is a significant difference in mortality based on both the age at diagnosis and in the setting of distant disease.
... Skin metastases of ACC are extremely rare; ACCs were previously reported as metastatic to skin, presenting as nodules on the neck, abdomen, shoulder, elbow, mental region, plantar surface, and digit nodules [3]. To the best of our knowledge, there is only one case of metastatic ACC of the submandibular gland to toes previously described in the literature; the patient in that case expired 10 months after the reported toe metastasis and 7 years after the initial diagnosis, with extensive metastatic disease [4]. ...
Key Clinical Message
Adenoid cystic carcinoma (ACC) is a rare malignant tumor of the salivary glands, with higher frequency in the submandibular gland, a prolonged clinical course, and poor long‐term survival. It tends to metastasize to lungs, bone, liver, brain, and rarely to skin. Comprehensive skin examination and appropriate follow‐up is recommended, since cutaneous metastasis represents disease progression, requiring management and prognosis adjustment.
... Other factors that can also influence the prognosis of ACC are the size and location of the tumor, the type of therapy used, the dose of radiation, and the presence of metastasis [11,12]. The case presented had a late diagnosis reflecting an infiltrative lesion that compromised the right face in the medial and inferior portion of the maxillary sinus ascending to the medial margin of the orbit. ...
... The mutilation caused by delayed treatment of cancer in the region of the face can cause much inconvenience to the patient of aesthetic, functional, and emotional natures, impacting in the self-esteem and often leading to social isolation [12]. In the presented case, even after undergoing reconstructive surgery, the patient still had oroantral communication and sinking of the face on the right side. ...
Adenoid cystic carcinoma is a cancer of the salivary gland that primarily affects the parotid, submandibular, and accessory salivary glands. Its growth is slow and it has infiltrative nature. A 46-year-old female patient coming from the rural area presented a lesion on the palate and reported pain in the region for three years. After incisional biopsy, and histopathological diagnosis of adenoid cystic carcinoma of the cribriform type of minor salivary gland, superior hemimaxillectomy and adjuvant treatment with radiotherapy and maxillofacial prosthetic rehabilitation were performed.
