A Case of Adenoid Cystic Carcinoma Presenting as Garcin's Syndrome without Mass Formation

Inose, Yuri; Kobayashi, Masaki; Hiroi, Atsuko; Toi, Sono; Maruyama, Kenji; Shimizu, Yuko; Shibata, Noriyuki; Yoshihara, Toshio; Uchiyama, Shinichiro

doi:10.2169/internalmedicine.51.5917

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…[2][3][4] In a report of a submandibular gland primary ACC with Garcin's syndrome, although brain MRI images showed no cranial nerve abnormalities, the disease progression was speculated to have begun with tumor cells invading the sympathetic plexus around the submandibular gland and the nearby internal carotid artery, extending to the cavernous sinus, invading cranial nerves III-VI, and invading the glossopharyngeal and vagus nerves from the anastomotic network between the trigeminal and sympathetic nerves. 2 As reported in the present study, there are anatomical network formations in the cranial nerves and their branches. 5 In this case, based on the findings of brain MRI and the previously reported cranial nerve anastomotic network, 5…”

Section: Discussionmentioning

confidence: 99%

Multiple cranial neuropathies secondary to adenoid cystic carcinoma of the parotid gland

Kano

Yamada

Muto

et al. 2022

Neurology & Clinical Neurosc

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Adenoid cystic carcinoma (ACC) is the second most common malignant salivary gland tumor, accounting for 7.5% to 10% of tumors. It is characterized by a slow growth rate and perineural invasion, and only a few treatment options are available for patients with advanced disease. 1 Parotid primary ACC often invades the facial nerve, causing facial paralysis. There are a few reports of multiple cranial neuropathies in ACC patients, but there are no reports to our knowledge demonstrating detection of the invasion pathway using imaging. Here, we report a case in which the progression pathway from ACC to the cranial nerves was evaluated based on brain magnetic resonance imaging (MRI).

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Section: Discussionmentioning

confidence: 99%

Multiple cranial neuropathies secondary to adenoid cystic carcinoma of the parotid gland

Kano

Yamada

Muto

et al. 2022

Neurology & Clinical Neurosc

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“…To the best of our knowledge, Garcin syndrome resulting from submandibular gland ACC has been described in only 2 previous case reports. [ 4 , 5 ] However, Garcin syndrome caused by PGACC has not been reported before.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] To our knowledge, only 2 cases of Garcin syndrome due to ACC have been previously reported. [ 4 , 5 ] Herein, we report a rare case of Garcin syndrome caused by parotid gland adenoid cystic carcinoma (PGACC).…”

Section: Introductionmentioning

confidence: 99%

Garcin syndrome caused by parotid gland adenoid cystic carcinoma

Chen¹,

Wang²,

Xu³

et al. 2017

Medicine

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Rationale:Garcin syndrome is characterized by the gradual involvement, and ultimately, unilateral paralysis of at least 7 and sometimes all cranial nerves, without intracranial hypertension or any long tract signs.Patient concerns:We report the case of a 59-year-old woman who presented with Garcin syndrome, which gradually progressed over a period of 2 years.Diagnosis:A left parotid gland biopsy revealed parotid gland adenoid cystic carcinoma (PGACC) with perineural invasion of a peripheral nerve bundle and lymph node metastasis.Interventions:The patient was treated 3 times with local-field palliative radiotherapy.Outcomes:She died after several months.Lessons:To the best of our knowledge, this is the first report of PGACC presenting as Garcin syndrome. PGACC is a rare tumor with a high propensity for perineural spread, and it should be considered as a possible cause of Garcin syndrome.

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“…Surgery for lesions in the cavernous sinus has always been a surgical challenge because of the high functional importance of this region and the associated high morbidity (10). However, the recent advances in endoscope technology allows for adequate exposure of this region with a reduction in surgical morbidity (7).…”

Section: B a Hayashi Y Et Al: Adenoid Cystic Carcinoma In Cavernous mentioning

confidence: 99%

Adenoid cystic carcinoma in the cavernous sinus diagnosed with endoscopic endonasal approach

Hayashi

Iwato²,

Kita³

et al. 2014

Turkish Neurosurgery

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A 42-year-old woman presented with right oculomotor, abducens, and trigeminal palsy. Neuroimaging revealed a small lesion in the right cavernous sinus mimicking meningioma. Because the symptoms gradually worsened, the patient underwent an endoscopic endonasal transsphenoidal surgery for tumor biopsy. Histological examination of the surgical specimen revealed adenoid cystic carcinoma (ACC). Before and after the operation, no evidence of other primary lesions could be detected. The patient was treated with stereotactic radiosurgery (SRS). ACC in the cavernous sinus can be difficult to diagnosis before histological confirmation, because it is extremely rare as a primary lesion and resembles a cavernous sinus meningioma on neuroimaging studies. Two years after the first SRS, the tumor recurred along the trigeminal nerve and SRS was performed again. Our study illustrates that in case in which a lesion in the cavernous sinus progresses on neurological and neuroimaging studies, a biopsy should be taken to provide most accurate diagnosis and treatment.KEywoRds: Adenoid cystic carcinoma, Cavernous sinus, Endonasal approach, Endoscope, Radiosurgery ÖZ 42 yaşındaki bir kadın sağ okülomotor, abdusens ve trigeminal sinir paralizileri ile başvurdu. Nörogörüntüleme sağ kavernöz sinüste menenjiyomu taklit eden küçük bir lezyon saptadı. Belirtiler yavaş yavaş kötüleştiği için, hastaya tümör biyopsisi için endoskopik endonazal transsfenoidal cerrahi uygulandı. Cerrahi örneğin histolojik incelemesinde adenoid kistik karsinom (ACC) saptandı. Operasyon öncesi ve sonrasında başka bir primer lezyon bulgusu saptanmadı. Hasta stereotaktik radyocerrahi (SRS) ile tedavi edildi. Bir primer lezyon olarak son derece nadir görüldüğü ve beyin görüntüleme çalışmalarında kavernöz sinüs menenjiyomuna benzediği için kavernöz sinüsteki ACC'un tanısını histolojik teyitten önce koymak zor olabilir. İlk SRS'den iki yıl sonra tümör trigeminal sinir boyunca tekrarladı ve yeniden SRS uygulandı. Çalışmamız nörolojik ve beyin görüntüleme çalışmalarında bir lezyonun kavernöz sinüste ilerlediği olgularda en doğru tanı ve tedaviyi sağlamak için biyopsinin alınması gerektiğini göstermektedir.

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A Case of Adenoid Cystic Carcinoma Presenting as Garcin's Syndrome without Mass Formation

Cited by 7 publications

References 18 publications

Multiple cranial neuropathies secondary to adenoid cystic carcinoma of the parotid gland

Multiple cranial neuropathies secondary to adenoid cystic carcinoma of the parotid gland

Garcin syndrome caused by parotid gland adenoid cystic carcinoma

Adenoid cystic carcinoma in the cavernous sinus diagnosed with endoscopic endonasal approach

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