Adenoid cystic carcinoma of the sublingual gland developing lung metastasis 20 years after primary treatment

Ohta, Keiichi; Matsuda, Shinpei; Okada, Ai; Sato, Masato; Imamura, Yoshiaki; Yoshimura, Hitoshi

doi:10.1097/md.0000000000028098

Cited by 9 publications

(9 citation statements)

References 43 publications

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“…The risk factors for lung metastasis include tumor size, perineural invasion and local recurrence [2]. Lung metastasis in ACC is usually asymptomatic for a long time and a size more than 2.5 centimetres has been identified as a risk factor for metastasis [2,9]. In the present case, the clinical presentation was similar to that reported in literature except lack of paresthesia [2,8,9].…”

Section: Discussionsupporting

confidence: 79%

“…The slow but constant growth, numerous local recurrences, and hematogenous dissemination, primarily to the lung, liver, bone, and brain, are characteristics of ACC's natural history [8]. The risk factors for lung metastasis include tumor size, perineural invasion and local recurrence [2]. Lung metastasis in ACC is usually asymptomatic for a long time and a size more than 2.5 centimetres has been identified as a risk factor for metastasis [2,9].…”

Section: Discussionmentioning

confidence: 99%

“…The primary sites which metastasize to the oral cavity include breast, lung, prostate and kidney in decreasing order of incidence [1]. Since it is a bidirectional phenomenon the metastatic sites most favoured by carcinomas from oral cavity are mainly lung, followed by bone and liver [2]. One of serious concerns about malignant tumors is their ability to metastasize, whereby the tumor cells detach from the primary tumor and invade adjacent tissues and enter the lymphatics or vascular compartment before getting lodged at a distant site.…”

Section: Introductionmentioning

confidence: 99%

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Finding the Way Back Home: Report of 2 Cases of Oral Metastasis

Sharma,

Narwal

et al. 2023

DOBCR

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Around 1-1.5 % of all malignant tumors in oral cavity are caused by metastatic dissemination to this region. Lung, kidney, breast, bone and colorectal regions are primary sites which act as source of metastases to oral cavity. Similarly, metastasis from primary oral malignancy to distant sites is not uncommon with metastasis mainly occurring to lung, followed by bone and liver. Here we report 2 cases showing different primary origins but presentation in oral cavity being the first symptom. One case is of an 82 year old male with a complaint of swelling in right mandible and a diagnosis of prostatic adenocarcinoma metastasizing to oral cavity was established. The other case presented here is of a 42 year old male with pain and swelling in right mandible. The diagnosis of adenoid cystic carcinoma was made and a full body scan helped in early identification of metastatic deposits in lung. Despite the infrequent occurrence of metastases in oral region, dental surgeon should be aware of the possibilities for correct diagnostic conduction and subsequently, the initiation of treatment in early stages of disease.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Finding the Way Back Home: Report of 2 Cases of Oral Metastasis

Sharma,

Narwal

et al. 2023

DOBCR

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“…When looking at ACC-specific post-PM survival outcomes, the results are heterogenous. There are multiple single-patient case reports of PM for ACC reporting varied clinical benefit, with differences in survival largely dictated by the development of subsequent distinct lung lesions or new metastases at non-pulmonary sites [ 130 , 131 , 132 , 133 ]. We identified 10 studies which included multiple ACC patients undergoing PM and reported ACC-specific survival data (as compared to the 12 reports above that presented aggregate outcomes across histologies).…”

Section: Local Therapy For Oligometastatic Lung Diseasementioning

confidence: 99%

Approaches to the Management of Metastatic Adenoid Cystic Carcinoma

Lee

Wai

Chan

et al. 2022

Cancers

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High rates of recurrence and distant metastasis are a foremost challenge in the management of adenoid cystic carcinoma (ACC), occurring in approximately 40% of all ACC patients. Despite the morbidity and mortality resulting from recurrent/metastatic (R/M) disease, there are no FDA-approved systemic agents for these patients. In this review, we summarize pertinent ACC pathophysiology and its implications for different systemic treatment regimens in R/M ACC. We review the evidence for the most widely used systemic agents — cytotoxic chemotherapy and tyrosine kinase inhibitors (TKIs) targeting VEGFR — in addition to immune checkpoint inhibitors and non-TKI biologic agents. Exciting emerging targets for R/M ACC, including inhibitors of Notch signaling, stemness, PRMT5, and Axl, are also discussed. Lastly, we review local therapies for small-volume lung disease in patients with oligometastatic ACC, specifically pulmonary metastasectomy and stereotactic body radiation therapy (SBRT). Future development of targeted molecular agents which exploit the underlying biology of this disease may yield novel therapeutic options to improve clinical outcomes in patients with R/M ACC.

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“…Lung is the most common site of distant metastasis of ACC derived from the head and neck, followed by bone, liver, and brain (4,5). In even rarer cases, ACC may arise from the submucosal tracheobronchial glands in the pulmonary system, and this accounts for a mere 0.04-0.2% of all primary lung tumors (6)(7)(8). It is difficult to distinguish between primary ACC of the lung (PACCL) and metastatic ACC of the lung (ACCL), as both conditions manifest atypical respiratory obstructive symptoms, including cough, chest pain, and dyspnea (2,9,10).…”

Section: Introductionmentioning

confidence: 99%

Clinical use of 18F-FDG PET/CT in the differential diagnosis of patients with primary and secondary adenoid cystic carcinoma of the lung: a retrospective cohort study

Sun¹,

Gu²,

Yuan³

et al. 2022

Transl Lung Cancer Res

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Background: Adenoid cystic carcinoma (ACC) of the lung (ACCL) is a rare malignancy and includes primary ACCL (PACCL) and secondary ACCL (SACCL) metastasized from the ACC of the head and neck.Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) has been shown to be useful in the differential diagnosis between primary and metastatic lung lesions. This study retrospectively investigated the role of 18 F-FDG PET/CT in combination with clinicopathological findings in the management of patients with primary or secondary ACCL.Methods: Clinicopathological characteristics and 18 F-FDG PET/CT metabolic parameters of 29 patients with PACCL and 11 patients with SACCL with pathological confirmation as gold standard were retrospectively collected. The association between PET/CT metabolic parameters and clinicopathological features was explored. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal maximum standard uptake value (SUV max ) cut-off value to distinguish PACCL from SACCL. The prognostic value of PET/CT metabolic parameters and clinicopathological features was evaluated by Cox regression analysis.Results: SACCL patients more often presented with multiple ACC lesions in the peripheral lung (81.8% vs. 17.2%, P<0.05) and tended to be asymptomatic compared to patients with PACCL (72.7% versus 27.6%, P<0.05). The SUV max was significantly higher in PACCL patients compared to SACCL patients (median 4.4 vs. 2.8, P<0.05). Furthermore, at a cut-off value of 3.2 for SUV max , the sensitivity and specificity of 18 F-FDG PET/CT in distinguishing PACCL from SACCL were 82.8% and 72.7%, respectively. Higher SUV max of ACCL was observed in patients with clinical symptoms, fewer ACC lesions, or larger tumor size (P<0.05).The median PFS of ACCL patients was 71.1 months, and the 12-and 24-month PFS rates were 96.1% and 91.6%, respectively. Univariate Cox regression analysis showed that SACCL from metastasis, lesions located ^ ORCID: 0000-0002-9479-132X. reporting checklist (available at https://tlcr.amegroups.com/ article/view/10.21037/tlcr-22-509/rc). Methods PatientsA total of 40 consecutive patients with pathologically confirmed ACCL who underwent 18 F-FDG PET/ CT examination in the Guangdong Provincial People's Hospital or the Shanghai Pulmonary Hospital from July 2008 to May 2021 were retrospectively included in this study. The following inclusion criteria were applied: (I) patients underwent tumor resection or puncture biopsy for pathological type confirmation within 2 weeks after the 18 F-FDG PET/CT scan; (II) patients could have a history at the peripheral lung or multiple ACC lesions present in the lung, were associated with poorer PFS (P<0.05).However, multivariate Cox regression analysis showed that none of the variables examined were independent predictors of prognosis.Conclusions: The use of 18 F-FDG PET/CT in combination with assessment of clinicopathological features was helpful in distinguishing PACCL from SACCL, which could provide guidan...

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Adenoid cystic carcinoma of the sublingual gland developing lung metastasis 20 years after primary treatment

Cited by 9 publications

References 43 publications

Finding the Way Back Home: Report of 2 Cases of Oral Metastasis

Finding the Way Back Home: Report of 2 Cases of Oral Metastasis

Approaches to the Management of Metastatic Adenoid Cystic Carcinoma

Clinical use of 18F-FDG PET/CT in the differential diagnosis of patients with primary and secondary adenoid cystic carcinoma of the lung: a retrospective cohort study

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