Lymph node involvement by direct extension in adenoid cystic carcinoma.Absence of classic embolic lymph node metastasis

Allen, M. Shannon; Marsh, W.

doi:10.1002/1097-0142(197611)38:5<2017::aid-cncr2820380525>3.0.co;2-o

Cited by 57 publications

(25 citation statements)

References 23 publications

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“…8 The abundant expression of CXCR4 in the predominantly hematogenously metastasizing ACC suggests that CXCR4 may play a role in directing ACC cells to their metastatic sites. In contrast to the frequent hematogenous dissemination, lymphogenous metastases in ACC are extremely rare, 4,46,47 despite the fact that the lymph nodes are also an abundant source of CXCL12. Although several studies have suggested a role for CXCR4 in lymph node metastasis, [48][49][50] accumulating evidence suggests that CXCR4 is not a major participant in lymphatic tumor spread, including large-scale gene expression data in metastatic head and neck SCC.…”

Section: Discussionmentioning

confidence: 99%

Chemokine receptors in head and neck cancer: Association with metastatic spread and regulation during chemotherapy

Müller

Sonkoly

Eulert

et al. 2005

Intl Journal of Cancer

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Head and neck carcinomas are histologically and clinically heterogeneous. While squamous cell carcinomas (SCC) are characterized by lymphogenous spread, adenoid cystic carcinomas (ACC) disseminate preferentially hematogenously. To study cellular and molecular mechanisms of organ-specific metastasis, we used SCC and ACC cell lines and tumor tissues, obtained from patients with primary or metastatic disease. Comprehensive analysis at the mRNA and protein level of human chemokine receptors showed that SCC and ACC cells exhibited distinct and nonrandom expression profiles for these receptors. SCC predominantly expressed receptors for chemokines homeostatically expressed in lymph nodes, including CC chemokine receptor (CCR) 7 and CXC chemokine receptor (CXCR)5. No difference in expression of chemokine receptors was seen in primary SCC and corresponding lymph node metastases. In contrast to SCC, ACC cells primarily expressed CXCR4. In chemotaxis assays, ACC cells were responsive to CXCL12, the ligand for CXCR4. Exposure of ACC cells to cisplatin resulted in upregulation of CXCR4 on the cell surface, which was repressed by the transcriptional inhibitor, a-amanitin. Treatment of ACC cells with CXCL12 resulted in the activation of Akt and ERK1/2 pathways. Furthermore, CXCL12 suppressed the rate of apoptosis induced by cisplatin in ACC cells, suggesting that signaling via CXCR4 may be part of a tumor cell survival program. Discrimination of the chemokine receptor profile in SCC and ACC in vitro and in tissues provided insights into their distinct biologic and clinical characteristics as well as indications that chemokine receptors might serve as future therapeutic targets in these malignancies. ' 2005 Wiley-Liss, Inc.Key words: head and neck cancer; squamous cell carcinoma; adenoid cystic carcinoma; chemokine receptor; metastasis Head and neck carcinomas (HNC) include tumors with different histological phenotypes and distinct clinical characteristics. Squamous cell carcinomas (SCC) of the upper aerodigestive tract mucosa represent the most common histological subtype.

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Section: Discussionmentioning

confidence: 99%

Chemokine receptors in head and neck cancer: Association with metastatic spread and regulation during chemotherapy

Müller

Sonkoly

Eulert

et al. 2005

Intl Journal of Cancer

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“…Adenoid cystic carcinomas, although often fatal, are more indolent neoplasms that unlike nonkeratinizing SCCs almost never metastasize to regional lymph nodes. 2,41 Nonkeratinizing SCCs often show continuity with the overlying surface epithelium, are often associated with dysplasia of the overlying epithelium, and often contain foci of keratinization. These features are not found in adenoid cystic carcinomas.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…As mentioned, embolic lymph node metastases are rare with true adenoid cystic carcinoma, which more often metastases hematogenously. 2 Immunohistochemistry is of some value in distinguishing these 2 tumor types when confronted with small biopsy specimens. Over 60% of adenoid cystic carcinomas with a cribriform growth pattern are immunoreactive for smooth muscle actin and even muscle-specific actin.…”

Section: Differential Diagnosismentioning

confidence: 99%

Human Papillomavirus-associated Squamous Cell Carcinoma of the Upper Aerodigestive Tract

Stelow

Jo²,

Stoler³

et al. 2010

American Journal of Surgical Pathology

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The association of human papillomavirus with the development of head and neck squamous cell carcinomas has been better elucidated over the past 20 years. In this review article, we examine the role of the virus in the development of these tumors. We discuss the clinical and pathologic features of human papillomavirus-associated squamous cell carcinomas of the head and neck. Immunohistochemical findings and those of other ancillary techniques are also reviewed. We further review the prognosis and treatment of these tumors. Finally, a detailed discussion is provided regarding the differential diagnosis that must be considered when confronting these squamous neoplasms.

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“…This reduces loco-regional recurrence and increases disease free survival rates [8,9]. Metastasis to the lymph nodes is rare and hence neck dissection is usually not warranted [10].…”

Section: Discussionmentioning

confidence: 99%

Extradural Spinal Metastasis of Adenoid Cystic Carcinoma (ACC): A Case Report

Kumar¹

2015

JCDR

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A 45-year-old male presented to the neurosurgery out patient department with diffuse low back pain radiating to the right girdle since two months and inability to walk since two days. The pain was continuous in nature, exaggerated on activity and was persistent during the night with relief on taking analgesics. He had no associated co-morbid illness and or habituations. There was no history of trauma or tuberculosis.Patient gave a past history of primary submandibular gland tumour resection 11 years back followed by radiation therapy. The diagnosis of ACC was rendered on the excised specimen (as per outside histopathology reports). He was advised an FDG-PET (Positron emission testing) scan, however differed the same. Nine years later, he developed a recurrent nodule at the previous scar and was detected to have recurrent disease on fine needle aspiration cytology. He underwent a wide local excision of the lesion with modified radical neck dissection (done at KMC, Manipal). The final histopathology was reported as ACC with negative margins and nodal metastasis (6 out of 12 isolated were positive for metastasis). He deferred palliative radiation therapy and was kept on regular follow-up. examinationOn clinical examination patient had mild spastic gait (Ashworth grade 4) [1] with bilateral lower limb spasticity. Power was 5/5 in both lower limbs. There was sensory loss below L1 level on the right side, and below L3 on the left side with gross involvement of the posterior column with no involvement of bowel or bladder. Bilateral knee and ankle jerk were brisk (3+) [1]. Mouth opening was restricted with Grade II trismus, intraoral examination revealing a densely fibrosed buccal mucosa [2] on the irradiated side. Rest of the oral cavity examination was unremarkable. He had a keloid formation over the operative site. On the outset, with the history of malignancy and an acute progression of lower limb motor function loss, our primary clinical diagnosis was (a) spinal metastasis, second was (b) epidural haematoma with compression over the traversing roots and less likely (c) bleed into a pre-existing meningioma. Adenoid cystic carcinoma (ACC) is a rare malignant tumour of the major salivary glands. It accounts for 10-15% of all salivary gland tumours and 1% of all head and neck tumours. Surgical resection followed by radiation is the choice of treatment for ACC. However, late loco-regional recurrence and metastasis is often seen emphasizing the importance of long-term follow-up.We report an unusual case of extradural metastasis of ACC in the dorsal spine. The primary submandibular gland tumour was resected 11 y back. A recurrence had been detected two years prior to the occurrence of spinal metastasis. Surgical decompression was done which was followed by palliative radiotherapy. Patient is symptomatically better, ambulant and on regular follow-up.Keywords: Adenoid cystic carcinoma, Compressive syndrome, Extradural spinal metastasis, Perineural invasion InvestigationMagnetic resonance imaging (MRI) of the dorso-lumbar sp...

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Lymph node involvement by direct extension in adenoid cystic carcinoma.Absence of classic embolic lymph node metastasis

Cited by 57 publications

References 23 publications

Chemokine receptors in head and neck cancer: Association with metastatic spread and regulation during chemotherapy

Chemokine receptors in head and neck cancer: Association with metastatic spread and regulation during chemotherapy

Human Papillomavirus-associated Squamous Cell Carcinoma of the Upper Aerodigestive Tract

Extradural Spinal Metastasis of Adenoid Cystic Carcinoma (ACC): A Case Report

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