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Adenoid cystic carcinoma (cylindroma) of the trachea masquerading as asthma.

A 40-year-old woman was admitted with upper airway obstruction; chest roentgenogram with tomograms, laryngoscopy, and bronchoscopy verified the presence of a subglottic tumor. Spirometry disclosed a maximum inspiratory flow rate more reduced than in the maximum expiratory flow rate, suggestive of upper airway obstruction. The pathologic conditions were consistent with cystic adenoid carcinoma (cylindroma) of the trachea. The patient underwent tracheostomy and total laryngectomy with an uneventful recovery. No evidence of local extension or distant metastases were evident at time of surgery.

Adult

Pericardial reconstruction of the membranous trachea after resection of adenoid cystic carcinoma (cylindroma).

An intraluminal adenoid cystic carcinoma (cylindroma) in the patient reported herein involved just the membranous portion of the distal region of the trachea and extended caudally to include the carina and the membranous portions of both main-stem bronchi--a total linear involvement of 6 cm. The tumor occluded 90% of the airway in its greatest extension. Conservative resection of this extensive tumor was successfully performed by membranous tracheal reconstruction with a pedicled autogenous pericardial patch graft.

Bronchial Neoplasms

Primary adenoid cystic carcinoma of skin.

Two primary adenoid cystic carcinomas of skin were studied histologically and histochemically. Histologically, they closely resemble adenoid cystic carcinoma found in other tissues but in the skin must be distinguished from aggressive basal cell carcinomas. The natural history of these tumors and of those collected from the literature suggest a long indolent and progressive course. Local excision with meticulous histologic control of the surgical margins appears to be an appropriate therapeutic strategy. Thus far lymph node metastases have not been observed.

Adult

Distribution of mucosubstances in adenoid cystic carcinoma.

The distribution of mucosubstances in adenoid cystic carcinoma was investigated, and an attempt was made to characterize histochemically the various mucosubstances present. For these purposes the high iron diamine technique (HID), as well as the Astra blue, aldehyde fuchsin and Alcian blue staining methods were employed. Alcian blue was further combined with the periodic acid-Schiff (PAS) technique, the Alcian blue being applied at pH levels between 0.5 and 2.5. In addition the effect of neuraminidase and hyaluronidase treatment as well as methylation and acid hydrolysis procedures on the staining qualities were studied. Acidic mucosubstances with varying histochemical properties were present in different structures of the neoplasm. The characteristic pseudocyst, a major structural component of the neoplasm, stained strongly with HID, Astra blue, aldehyde fuchsin and Alcian blue at low pH. These staining reactions were markedly suppressed by hyaluronidase treatment, and are apparently attributable to the presence of chondroitin 4- and/or 6-sulfate. Employing the Alcian blue-critical electrolyte concentration technique, the basophilia of the pseudocysts was suppressed at a concentration of 0.5-0.6 M MgCl2, which might indicate polysaccharides of relatively low degree of sulfation. An additional, non-sulfated acid mucin could also be demonstrated in these structures. In certain duct and gland like structures of the tumours, a change in staining pattern from blue or blue-red to red could be observed after exposure of the sections to neuraminidase and subsequent staining with the Alcian blue (pH 2.5)-PAS sequence. Similar observations were also made when the pH of the Alcian blue was lowered to 1.5-1.0, as well as after acid hydrolysis. These findings afford evidence for the presence of a neuraminidase susceptive sialomucin in certain epithelial secretions of the tumor. At the ultrastructural level the replicated basement lamina of the pseudocysts displayed a strong positive reaction with the PA-CrA-silver staining technique. Furthermore, amorphous material within the lumina of small duct like structures also displayed a positive reaction. The amorphous material of the cystic compartments was less reactive.

Carcinoma, Adenoid Cystic

Adenoid cystic carcinoma with orbital and cranial metastases: case report.

Adenoid cystic carcinoma of the paranasal sinuses was demonstrated in a patient who subsequently developed a metastatic lesion to both orbits resulting in total blindness. While there are reports of extension of adenoid cystic carcinoma of the lacrimal gland to the adjacent orbit, this patient is an example of orbital extension of an adenoid cystic carcinoma of minor salivary gland originating in a paranasal sinus. The frequency and classification of this tumor also is reviewed.

Blindness

Morphologic and biologic characteristics of adenoid cystic carcinoma cells of the salivary gland.

Adenoid cystic carcinoma cells cultivated in monolayer and sponge matrix culture, or implanted on the chorioallantoic membrane (CAM) of embryonated eggs, were observed morphologically, and the glycosaminoglycan components in the tumor tissue were analyzed. This tumor tissue contained a large amount of glycosaminoglycans, composed of chondroitin 4- and 6-sulfate, heparan sulfate, hyaluronic acid, and a small amount of dermatan sulfate. In monolayer culture spindle cells proliferated vigorously as multilayer, and secreated mucinous material. In sponge matrix culture, the proliferating cells became embedded in the material produced by the cells themselves. A trace of fine fibers stained with orceine was observed in the intercellular material in culture. Histologic sections of the implants grown on CAM showed that the tumor cells arranged in various structures produced a large amount of mucinous material that spread into the stromal area without any contribution from the mesenchymal element. The morphologic and biologic characteristics of these tumor cells are quite similar to those of pleomorphic adenoma.

Adenoma

Intraoral adenoid cystic carcinoma.

A case report of adenoid cytic carcinoma of the palate is presented. The clinical manifestations, diagnostic criteria, surgical resection, and prosthetic reconstruction of the patient are discussed.

Carcinoma, Adenoid Cystic

Metastasis of adenoid cystic carcinoma of the mandible to the Gasserian ganglion.

A case of adenoid cystic carcinoma of the mandible in a 47-year-old woman metastasized to the Gasserian ganglion probably through the perineural space of the inferior alveolar nerve. The patient was treated by irradiation after excision of the tumor from the ganglion. She is currently an outpatient in the oral and maxillofacial surgery department; two years and seven months after the first examination, there is no sign of recurrence or metastasis of adenoid cystic carcinoma.

Carcinoma, Adenoid Cystic

Primary adenoid cystic carcinoma (cylindroma) of the trachea.

Two cases of adenoid cystic carcinoma of the trachea, and a review of the literature, are presented. This unusual and often undiagnosed tumor closely mimics asthma and chronic bronchitis. Although many patients die within 2 to 3 years of the onset of symptoms without appropriate treatment, adequate therapy should lead to survival of 10 years or more. The radiologist should make the initial diagnosis by noting the tumor, which is frequently located posterolaterally and in the middle third of the trachea.

Carcinoma, Adenoid Cystic

Morphology and the natural history of cribriform adenocarcinoma (adenoid cystic carcinoma).

Forty-three examples of cribriform adenocarcinoma (adenoid cystic carcinoma) of mixed glandular origin are reported. Structural studies emphasise the classical cribriform pattern which indicates the capacity of this neoplasm to behave as both an epithelial and a connective tissue type tumour. In terms of survival, it does not appear to be an malignant as other forms of carcinoma arising in similar anatomical locations. The five-year crude survival rate (56%) compares favourably with that of other carcinomas of the palate and paranasal sinuses. A recurrence rate of the order of 20% may persist up to 10 years after primary treatment, and while this is not inimical to longer survival there is clearly a high morbidity.

Adult

Clinical and histological malignancy of adenoid cystic carcinoma.

The authors report on 25 cases of adenoid cystic carcinoma of the head and neck region. The tumours were divided into 4 histological malignancy groups. Treatment generally consisted of surgery performed with as large a margin as possible, in combination with split course million volt therapy, about 6,000 rads, usually given preoperatively. It was found that the patients in the groups of lower malignancy generally managed for a comparatively long time without a clinically demonstrable recurrence, while the patients in the groups of higher malignancy relapsed rather quickly and often had metastases. The patients in the groups of higher malignancy also died relatively soon after the histological tumour preparations.

Adult

Primary adenoid cystic carcinoma of the esophagus: report of a case.

A case of primary adenoid cystic carcinoma of the esophagus is reported. A 51-year-old male patient had a tumor in the lower third of the esophagus which was incidentally found during an examination for cholelithiasis, and resected successfully. The tumor exhibited a polypoid appearance covered by normal esophageal epithelium, localized entirely in the submucosal layer, and morphologically identical to adenoid cystic carcinoma in the salivary glands. The patient is still alive and well three and one-half years after surgery. This seems to be a typical case of adenoid cystic carcinoma of the esophagus arising from the submucosal esophageal gland.

Aged

Adenoid cystic carcinoma of the breast.

We have presented a case of adenoid cystic carcinoma of the breast and reviewed the literature, with emphasis on the behavior of this rare neoplasm and the fact that its prognosis appears to be more favorable than that of other more common histologic types of breast cancer. The accumulated information about adenoid cystic carcinoma of the breast that exists to date is insufficient to allow dogmatic statements, but one can conclude that total mastectomy seems to be the treatment of choice in selected cases.

Breast Neoplasms

Cytologic characteristics of adenoid cystic carcinoma of the cervix uteri.

Cytologic characteristics of three cases of adenoid cystic carcinoma of the cervix uteri are reviewed. The clusters of malignant cells tend to form large acini and mimic the pattern seen in histologic sections. The resemblance to cells of adenocarcinoma of the endometrium is noted. When the acinar pattern is recognized in cervical smears, adenoid cystic carcinoma of the cervix may be suspected.

Aged

Adenoid cystic carcinoma of the vulva. Malignant cylindroma.

A case of adenoid cystic carcinoma (cylindroma) of the vulva is presented, reviewing the clinical course and response to therapy over a 5-year period. Only 9 previous cases had been reported by 1963. Several sources of cell origin had been previously suggested. Findings and histology in this case support a relation to a similar tumor occurring in other sites of the upper respiratory tract and salivary gland.

Carcinoma, Adenoid Cystic

[Adenoid cystic carcinoma extended to Gasserian ganglion-report of two cases (author's transl)].

Adenoid cystic carcinoma is an uncommon tumor, especially in cases of its extension into the cranial cavity. Two cases of this tumor involving Gasserian ganglion were reported. The first case was a 47 year old female who developed paresis of the right side fifth cranial nerve. The plain skull X-ray of the axial view demonstrated enlargement of the right sided foramen ovale. The tumor was removed exploring the middle fossa extradurally, however its extention through the foramen ovale remained behind. A small induration was found at the base of the oral cavity postoperatively, and the biopsy revealed characteristic findings of adenoid cystic carcinoma histologically. Radiation therapy was followed by considerable clinical improvement.

Adult

Partial remission of advanced adenoid cystic carcinoma obtained with adriamycin: a case report with a review of the literature.

Adenoid cystic carcinoma is relatively uncommon and often originates from the salivary glands. Although distant metastases develop rather frequently no satisfactory form of therapy has been reported. We achieved a partial remission with adriamycin in a patient with advanced metastases of adenoid cystic carcinoma. This case is described, and a short review of the literature, including papers on the treatment of advanced disease, is also given.

Carcinoma, Adenoid Cystic

A qualitative and quantitative electronmicroscopic study of the structure of the adenoid cystic carcinoma of human minor salivary glands.

The fine structural characteristics of five adenoid cystic carcinomas of human minor salivary galnds and a quantitative assessment of the relative volumes occupied by morphologically defined cell types in these tumors are reported. We observed that the cyst-like spaces which give the characteristic cribriform pattern to the adenoid cystic carcinoma contain replicated basement membrane-like materail. Material comprisimg aggregates of fine tubules having a median diameter of 270 A, and rounded, electron dense bodies were noted within duct-like lumena of one tumor. In addition, dilatation of the intercellular spaces and squamous metaplasia were noted. From 500 electronmicrographs obtained by standardized techniques and used for the morphological part of the study, 175 were selected by a random sampling method and analyzed by the stereological technique of point counting. This method demonstrated that duct type cells occupied 75% by volume of the tumor in these glands; myoepithelial cells occupied 3%, acinar cells occupied 2%, and other tissues occupied 22% of the tumors. These proportions differ significantly (P less than 0.001) from our previously published figures for normal specimens of these glands.

Basement Membrane