Adenoid cystic carcinoma of the breast – an aggressive presentation with pulmonary, kidney, and brain metastases: a case report

Mhamdi, Hasnae Alaoui; Kourié, Hampig Raphaël; Jungels, Christiane; Aftimos, Philippe; Belbaraka, Rhizlane; Piccart‐Gebhart, Martine

doi:10.1186/s13256-017-1459-0

Cited by 18 publications

(25 citation statements)

References 16 publications

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“…Our clinical review results are reported in (Table 1). Mean LRFS reported by case reports was 24 months (range 20-48) [3,4,8,[10][11][12]. Mean DFS reported by case series and retrospective series was 87.9% (range 69-100%) [2,5,[13][14][15][16].…”

Section: Resultsmentioning

confidence: 99%

“…Mean DFS reported by case series and retrospective series was 87.9% (range 69-100%) [2,5,[13][14][15][16]. Mean OS reported in case reports was 30 months (range 12-84) [3,4,8,[10][11][12]. Mean 5-years OS reported in retrospective series was 89.7% [2,16,17].…”

Section: Resultsmentioning

confidence: 99%

“…ACCB usually affects women, in whom it is more frequent in the sixth decade of life [2]. Histologically presentation shows a double component both luminal epithelial and basal myoepithelial cells, without oestrogen, progesterone and Her-2 receptor expression [3,4]. Despite its belonging to triplenegative class breast tumor, clinical presentation of this disease is usually isolated to breast gland, in 2% of pts patients (pts) there is a nodal involvement and rarely it can metastasize in other parenchyma [1,2,5,6].…”

Section: Aimmentioning

confidence: 99%

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The role of radiotherapy (RT) in the treatment of Adenoid Cystic Carcinoma of the Breast: case report of RT retreatment and literature review

Smaniotto¹,

Terribile²,

Marazzi³

et al. 2019

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This study reviews the recent literature on the role of definitive radiotherapy (RT) in the management of adenoid cystic carcinoma of the breast (ACCB) and presents comprehensive data on clinical outcomes. A case report of radiotherapy retreatment in ACCB is reported for first time in literature. Methods: The authors performed a literature review using PubMed (1981-2019) to identify all studies that match with keywords. Inclusion criteria were articles reporting patients underwent radiotherapy after ACCB diagnosis with follow up reporting. Data analyzed were number of pts, age, study design, multimodality treatment management with radiotherapy schedule, stage of disease, pathological risk factors, local relapse free survival (LFRS), metastases free survival (MFS) and overall survival (OS). Results: Of the 60 identified studies, 15 met the inclusion criteria. All studies had a retrospective design. Overall, 967 patients (median, 64; range, 1-478) were included. A high heterogeneity was found across studies in terms of pathological features available, local approach in multimodality management, adjuvant RT administration, and reported outcomes. Mean LRFS reported by case reports was 24 months (range 20-48). Mean DFS reported by case series and retrospective series was 87.9% (range 69-100%). Mean OS reported in case reports was 30 months (range 12-84). Mean 5-years OS reported in retrospective series was 89.7%. Mean 10-years OS reported in retrospective series was 78.7%. In some retrospective series radiotherapy was found significantly related to local control (p=0.03) and with an absolute survival benefit of 9% at 5 year and of 21% at 10 years (p=0.005). Conclusion and implications for practice: To our knowledge this is the first report on radiotherapy retreatment in ACCB local relapse. This study also reviews the recent literature on the role of adjuvant RT in the management of ACCB and presents comprehensive data on long-term clinical outcome. Some significant results about RT are improvement in local control and survival benefit also since at 10 years in some series. Further studies are needed to confirm these results.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Aimmentioning

confidence: 99%

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The role of radiotherapy (RT) in the treatment of Adenoid Cystic Carcinoma of the Breast: case report of RT retreatment and literature review

Smaniotto¹,

Terribile²,

Marazzi³

et al. 2019

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“…Lymph node involvement is very rare (not exceeding 2%), however, SLNB is required for ACC, as with any invasive breast primary. In a retrospective case series from with follow up of 20 years, patients with pure ACC (n = 20), out of a 15,749 total cases of invasive breast cancer, 15 of those had SLNB with pathologically node-negative lymph nodes, and no evidence of any lymph node involvement in 20 year follow up [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is no indication for adjuvant chemotherapy and several small studies suggest no survival benefit on overall survival [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Adenoid cystic carcinoma of the breast - Discordant size on imaging and pathology: A case report and review of literature

Agafonoff

Sobolewski

Braverman

2019

Annals of Medicine and Surgery

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Introduction Adenoid cystic carcinoma (ACC) is an uncommon tumour of the breast. It is known for its rare lymph node involvement and distant metastasis. A triple-negative breast cancer that has a favorable prognosis compared to other triple negative ductal carcinomas, it accounts for approximately 0.1–1% of all breast cancers. Presentation of case We report a case of a 69-year-old female with a palpable left breast mass who underwent multiple imaging modalities with significant size variance between the studies. Breast conserving therapy (BCT) was performed with axillary sentinel lymph node biopsy (SLNB) followed by radiation therapy (RT). Pathological examination confirmed the tumour as ACC. Discussion ACC, known as an persistent if low-grade malignant tumour of salivary gland, is considered to have low-malignant potential in the breast. It is a very rare subtype and from this scant data, there is minimal mention about size discrepancy between imaging modalities such as ultrasound and MRI. No consistent MRI features have been demonstrated, with the exception of T2 hyperintensity in larger lesions and T2 iso-intensity in smaller lesions. Ultrasound demonstrates primarily a hypoechoic or heterogenous mass with minimum vascularity, consistent with our radiographic findings. Conclusion ACC is a rare entity in breast cancer pathology. Its size can be highly variable as measured by various radiographic modalities, and final Pathology from the surgical specimen is, as always, required for an accurate tumoral diameter. With that caveat, careful utilization of pre-operative imaging modalities is critical in pre-surgical planning to choose the appropriate surgery.

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Adenoid cystic carcinoma cytology: Salivary gland and nonsalivary gland

Chowsilpa

An²,

Maleki

2020

Diagnostic Cytopathology

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Objectives: Adenoid cystic carcinoma (ACCA) is an uncommon primary malignancy of salivary glands and rarely nonsalivary tissue. This study aims to evaluate the diagnostic accuracy of ACCA on fine needle aspiration (FNA) material and the associated challenges. Methods: A search on electronic pathology database from 2006 to 2016 at The Johns Hopkins Hospital found 83 cytology specimens diagnosed as ACCA, 49 with histology follow-up. Results: Fifty-two females and 31 males were found ranging from 37 to 95 years old (mean 62.5). The tumor size was 1 to 11.5 cm (mean 3.4). FNAs were performed on 46 salivary glands (54.88%), 12 head and neck masses (14.45%), 9 lymph nodes (10.84%), 9 tracheas/lungs (10.84%), 4 vaginal/perineum/gluteal masses (4.82%), and one for each kidney, liver and abdominal/pelvic mass (1.21%). 83 FNA diagnoses revealed 3 nondiagnostics (3.61%), 20 neoplasms with unspecified features (24.10%), 30 basaloid neoplasms (36.14%), 18 ACCA (21.69%), and 12 other malignancies (14.46%). The accuracy of FNA in diagnosis of ACCA comparing to histologic follow-up in 49 cases was 87.5% sensitivity, 66.67% specificity, with 92.11% positive predictive value and 54.55% negative predictive value. The most common mimicker was pleomorphic adenoma. Conclusion: ACCA can be diagnosed not only in the salivary gland FNAs, but also respiratory tract, intra-abdominal, kidney, and gynecologic regions. FNA is a preferred technique to assess mass lesions. However, a diagnosis of ACCA on FNA material should be rendered with caution since there are benign and malignant neoplasms with overlapping features. Awareness of prior medical history and ancillary studies can improve the diagnosis. K E Y W O R D S adenoid cystic carcinoma, basaloid neoplasm, fine needle aspiration, nonsalivary gland adenoid cystic carcinoma, the Milan system for reporting salivary gland cytopathology 1 | INTRODUCTION Adenoid cystic carcinoma (ACCA) is an uncommon malignancy. It accounts for approximately 1% of all head and neck tumors and is a well-known salivary gland malignancy. The most common site is minor salivary glands, followed by parotid, submandibular, and sublingual glands. 1-4 However, the tumors may arise in other organs such as lacrimal glands, nasal and paranasal sinuses, larynx and trachea, breast, skin, and vulva. 2,3,5-12 Patients are in middle age or older during the initial presentation of the tumor, with high frequency in fifth and sixth decades. 2-4 Males and females are affected equally, 2 but some studies reported female

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Adenoid cystic carcinoma of the breast – an aggressive presentation with pulmonary, kidney, and brain metastases: a case report

Cited by 18 publications

References 16 publications

The role of radiotherapy (RT) in the treatment of Adenoid Cystic Carcinoma of the Breast: case report of RT retreatment and literature review

The role of radiotherapy (RT) in the treatment of Adenoid Cystic Carcinoma of the Breast: case report of RT retreatment and literature review

Adenoid cystic carcinoma of the breast - Discordant size on imaging and pathology: A case report and review of literature

Adenoid cystic carcinoma cytology: Salivary gland and nonsalivary gland

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