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Adenoid cystic carcinoma (ACC) is an aggressive malignant neoplasm of the secretory glands. Conventional chemotherapy has poor effectiveness against metastatic ACC. Thus, a novel effective therapy is needed against metastatic ACC. A majority of ACCs (up to 94%) express c-kit. Imatinib is monoclonal antibody with specific activity against c-kit but has not been found to be effective in treating patients with ACC in which c-kit is overexpressed and activated. The NF-κB and mTOR pathways have been shown that ubiquitously and concurrently activated, indicating that the inhibition of these pathways may represent a novel treatment approach for patients with ACC. Curcumin has been shown to inhibit NF-κB and NF-κB-related pathways. 43-year-old patient was diagnosed ACC from submandibular salivary gland. After complete resection of tumor adjuvant radiotherapy was initiated. Seven years later multiple lung metastases were detected and ACC was confirmed by re-biopsy. First-line chemotherapy failed. NF-κB and c-kit were overexpressed in the metastatic specimens. Therefore, we treated the patient with metastatic chemoresistant ACC with imatinib 400mg/day and intravenous curcumin 225mg/m(2) twice a week plus oral bioavailable curcumin Arantal(®) 2×84mg/day. At 24 months, we observed near complete anatomic and complete metabolic response. To our knowledge, this is the first report of a patient with a c-kit-positive ACC that is successfully treated with the combination of imatinib and curcumin in an integrative approach.

OBJECTIVE:The aim of the present study was to report our patients with pulmonary siderosis (PS) who were exposed to iron oxide and diagnosed with the minimally invasive surgical technique (video-assisted thoracic surgery [VATS]), and to provide a discussion of the relevant literature.METHODS:Hospital records of seven patients who were diagnosed with PS by VATS between 2008 and 2016 were retrospectively reviewed. VATS was performed for seven patients for whom no definitive diagnosis could be made with other diagnostic techniques.RESULTS:All 7 patients included in our study were male, and their mean age was 54 years. As for the profession, two patients were founders, two were grinders, and three were welders. All patients were operated with VATS. The patients were followed with chest radiograms and spirometric tests for an average of 24 (15–36) months. At the follow-up, the patients were not only free of progression but also they even showed regression.CONCLUSION:VATS is currently an established technique used for many diagnostic and therapeutic procedures, notably in chest surgery practice. We also advocate that VATS technique is an ideal method for making the pathological diagnosis of pneumoconioses when other methods fail to do so.

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