1/59. Primary cutaneous adenoid cystic carcinoma of the eyelid.PURPOSE: To report a case of primary cutaneous adenoid cystic carcinoma involving the eyelid. methods: We examined a 70-year-old woman with an 18-month history of a gradually enlarging, blue-colored mass in the medial third of the right upper eyelid. Excisional biopsy and additional resection of the medially infiltrated margin resulted in tumor-free edges. Superior cervical and orbital evaluations were performed. RESULTS: Histopathologic evaluation revealed a primary cutaneous adenoid cystic carcinoma. No gland pathology was documented. No tumor recurrence has been noted. CONCLUSION: Primary cutaneous adenoid cystic carcinoma, an uncommon tumor of the skin, should be added to the differential diagnosis of eyelid tumors.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/59. Primary orbito-cranial adenoid cystic carcinoma with torcular metastasis: a case report and review of the literature.Adenoid cystic carcinoma is a rare neoplasm arising from the exocrine glands such as salivary glands, lachrymal glands, upper respiratory tract, breast or uterine cervix. Intracranial involvement is commonly from direct skull base involvement, although metastasis may rarely be seen. The predisposition of the adenoid cystic carcinoma for perineural and perivascular invasion is the prime reason for the locally invasive character of the tumour, often extending into the cranium via foramina at the skull base. The authors report a case of primary orbito-cranial extradural adenoid cystic carcinoma and cranial metastasis away from the primary site. This patient initially had a local excision, and later an exenteration of the right eye followed by with radiotherapy. Within months she presented with an extradural cranial recurrence, distant torcular metastasis without any neurological deficit. craniotomy and radical excision was undertaken as these tumours have slow growth rates, and long term survival of the se patients even in the presence of local recurrence and metastasis has been well documented.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
3/59. Pulmonary epithelial-myoepithelial tumor of unproven malignant potential: report of a case and review of the literature.Epithelial-myoepithelial tumors of the lung are rare neoplasms whose biological behavior and clinical course still remain to be defined. A case of epithelial-myoepithelial tumor of the lung arising from bronchial mucosa-submucosa and occurring as a polypoid lesion of the upper left bronchus in a 47-year-old man is reported. The tumor did not infiltrate the cartilaginous wall of the bronchus and showed a biphasic histological appearance with a double layering of epithelial and myoepithelial cells. Myoepithelial spindle cells with eosinophilic cytoplasm were also observed. Mitotic figures were very rare and necrosis absent. Immunohistochemical study for epithelial and muscular markers confirmed the presence of a double-cell component in the tumor, namely epithelial and myoepithelial. The patient is alive and well, with no evidence of recurrent or metastatic disease 6 months after surgery. On the basis of the present case and the six previously reported cases, we suggest using the noncommittal term pulmonary epithelial-myoepithelial tumor of unproven malignant potential (PEMTUMP) for this type of neoplasm. In addition, we first introduce p63 as a novel marker for highlighting the myoepithelial cells of the respiratory tract and speculate on the role of these cells in the development of this unusual tumor.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
4/59. adenomyoepithelioma of the breast. A review of three cases with reappraisal of the fine needle aspiration biopsy findings.OBJECTIVE: To describe the fine needle aspiration cytology findings of adenomyoepithelioma of the breast, with histologic correlation. STUDY DESIGN: The author reviewed the cytologic findings of three cases of adenomyoepithelioma of the breast in the files of Pamela Youde Nethersole Eastern Hospital in a three-year period, 1998-2000. The diagnosis was confirmed by histologic examination, immunohistochemical study and electron microscopy. RESULTS: All cases showed similar cytologic findings. The direct smears and cytospin preparations contained an obvious biphasic cell population. There were clusters and sheets of benign apocrine cells admixed with clumps of bland-looking oval to spindle cells. The apocrine cells contained larger, round nuclei; prominent solitary nucleoli; and ample eosinophilic, granular cytoplasm. In contrast, the spindle cells had oval nuclei, fine chromatin, inconspicuous nucleoli and scanty amphophilic cytoplasm. A small number of named nuclei and foamy macrophages was noted in the background. The characteristic stromal elements seen in fibroepithelial tumor of the breast were not found. The myoepithelial nature of the spindle cells was confirmed by immunohistochemical and ultrastructural studies. Subsequent simple mastectomy and wide local excision were performed on cases 1 and 2, respectively, revealing focal carcinomatous transformation in the adenomyoepitheliomas. The carcinoma cells, however, were not sampled in the initial cytologic specimens. CONCLUSION: The cytologic features of adenomyoepithelioma, though variable and subtle, are characteristic enough for diagnosis. Recognition of the peculiar combination of benign apocrine cells and clumps of nondescript spindle cells should alert the cytologist to this rare but distinct entity, which carries a propensity for malignant transformation.- - - - - - - - - - ranking = 0.13426989795918keywords = back (Clic here for more details about this article) |
5/59. Cutaneous metastasis from adenoid cystic carcinoma of the parotid gland.BACKGROUND: Cutaneous metastasis from adenoid cystic carcinoma of the salivary gland is very rare. OBJECTIVE: To present an unusual case of cutaneous metastasis from adenoid cystic carcinoma of the right parotid gland. methods: A 63-year-old woman with multiple subcutaneous nodules on the abdomen and a gradually enlarged mass over the right parotid area was examined. A skin biopsy was taken from one of the abdominal nodules. RESULT: skin biopsy demonstrated the characteristic histopathologic features of metastatic adenoid cystic carcinoma. A subsequent computerized tomography of the head and neck revealed a huge soft tissue mass involving the right parotid gland. Computerized tomography of the chest revealed extensive nodular pleural thickening, and pleural biopsy also showed typical histopathologic features of metastatic adenoid cystic carcinoma. All of these results are consistent with the diagnosis of an adenoid cystic carcinoma of the right parotid gland with disseminated metastases. CONCLUSION: We report a rare case of cutaneous metastasis from adenoid cystic carcinoma of the right parotid gland. The presentation of cutaneous metastasis is often nonspecific and may mimic benign lesions. Subcutaneous nodules that are rapidly developing or eruptive, are rapidly growing and have stony hardness in nature, have pain or tenderness, and have nonhealing ulceration remind us of the possibility of cutaneous metastases. Dermatologists and dermatologic surgeons should keep the diagnosis of cutaneous metastasis in mind and always perform skin biopsy when encountering these lesions.- - - - - - - - - - ranking = 0.6900862244898keywords = chest (Clic here for more details about this article) |
6/59. Downgaze "hang-up" of the upper eyelid in patients with adult-onset ptosis: an important sign of possible orbital malignancy.PURPOSE: To highlight, in patients with adult-onset ptosis, the importance of upper eyelid hang-up during downgaze as a clinical sign of serious orbital disease. DESIGN: Retrospective, observational case series. patients AND methods: Retrospective review of the presenting clinical symptoms and signs for a series of seven patients, some referred for treatment of adult-onset ptosis, with hang-up of the upper eyelid on down-gaze. RESULTS: All patients had symptoms of upper eyelid ptosis at presentation, starting at ages ranging from 29 to 81 years (mean, 64 years; median, 70 years). All patients displayed marked hang-up of the affected upper lid on downgaze, and the levator excursion was reduced (range, 2-13 mm; mean, 9 mm) compared with the asymptomatic side. All patients with downgaze hang-up had associated orbital malignancy, but they otherwise had only minimal or no underlying orbital disease. Exophthalmometry varied between subtle (1 mm) relative enophthalmos in two cases, to mild relative proptosis (3/7 cases; range, 2-3 mm). Ipsilateral up gaze was reduced in 4 of 7 patients (57%). CONCLUSION: In contrast to patients with adult-onset blepharoptosis (resulting from dehiscence of the levator muscle aponeurosis), adults presenting with ptosis resulting from malignant infiltration of the upper orbital tissues may display hang-up of the upper eyelid in downgaze. This important sign should alert the clinician to the possibility of serious underlying orbital disease.- - - - - - - - - - ranking = 10keywords = upper (Clic here for more details about this article) |
7/59. Spinal metastasis of submandibular gland adenoid cystic carcinoma: a case report.BACKGROUND: Adenoid cystic carcinoma is a rare malignant tumor of the salivary glands, with pulmonary metastasis being the most common site of distant metastasis. CASE DESCRIPTION: The author reports an unusual case of intradural adenoid cystic carcinoma metastasis of the lumbar spine in a patient with recent prostate carcinoma suffering from progressive back pain. The primary submandibular tumor was resected 7 years before the appearance of the spine metastasis, and a prostatic carcinoma had been detected 1 year before. The patient died of systemically advanced disease a few months after surgical decompression. CONCLUSION: Late submandibular gland adenoid cystic carcinoma recurrence may present as an intradural lumbar spine metastasis. The case further displays difficulty in diagnosis and differentiation of metastasis in case of metachronous tumors.- - - - - - - - - - ranking = 0.13426989795918keywords = back (Clic here for more details about this article) |
8/59. One-stage operation for synchronous primary cancers of the lung and the trachea.A rare combination of synchronous primary adenocarcinoma of the right upper lobe of the lung and adenoid cystic carcinoma of the subglottic trachea was simultaneously managed by lobectomy with lymph node dissection and sleeve resection of the upper trachea through median sternotomy and cervical collar incisions. This combined approach should be a perfectly acceptable one for synchronous tumors of the proximal trachea and of the right upper and middle lobes and left upper lobe of the lung.- - - - - - - - - - ranking = 4keywords = upper (Clic here for more details about this article) |
9/59. Transmandibular transpterygoid approach to the nasopharynx, parapharyngeal space, and skull base.The nasopharynx, upper part of the parapharyngeal space, and skull base are relatively inaccessible to the surgeon without major postoperative complications. Operative fields reached by conventional approaches through the palate and maxillary sinus are too limited and narrow to remove extensive tumors. The authors applied a transmandibular transpterygoid approach for the removal of five residual nasopharyngeal carcinomas (NPCs) after full doses of irradiation, one pleomorphic adenoma of the nasopharynx, and one large parapharyngeal schwannoma extending into the jugular foramen. This approach offers a wide operative field so that large blood vessels and cranial nerves can be managed easily. All tumors were successfully resected. Two patients with benign neoplasma had uneventful recoveries after treatment. Of five patients with NPC, two are alive with no evidence of disease for 68 months and 50 months, respectively, while two died of metastases to the liver and bones. The other patient is alive with metastases in the lungs. No tumor recurred in the local primary site, however. Since the number of NPC cases is small, the usefulness of surgical removal of the postirradiation residual NPC is not clear. Our experience proved that the transmandibular transpterygoid approach is a practical method in the treatment of neoplastic lesions in the nasopharynx, parapharyngeal space, and skull base.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
10/59. A case of adenoid cystic carcinoma of the bronchus producing cancer-associated antigen, CA19-9.A 73-year-old male was admitted to Hyogo College of medicine Hospital for further evaluation of chest x-ray abnormalities. Chest roentgenogram taken at admission showed right lower lobe atelectasis and bronchoscopic examination revealed an endobronchial tumor obstructing the left lower lobe bronchus. The biopsy specimen showed cribriform adenoid cystic carcinoma. The serum CA19-9 level was markedly elevated at admission, leading to immunohistochemical analysis of the biopsy specimen. As a result, in the tumor, CA19-9 was positively stained. This is probably the first reported case of adenoid cystic carcinoma of the bronchus which produces CA19-9.- - - - - - - - - - ranking = 0.6900862244898keywords = chest (Clic here for more details about this article) |
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