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Adenoid cystic carcinoma of the external auditory canal.Ann
Otolaryngol Chir Cervicofac. 2007 May 21;
OBJECTIVES: To
report a case of adenoid cystic carcinoma of the external auditory
canal with petrous involvement. MATERIAL AND METHODS: A 50-year-old
woman was referred to our department for the management of a
necrotizing external otitis. Computed tomography and biopsy revealed
an adenoid cystic carcinoma of the external auditory canal. RESULTS:
The patient was treated by complete surgical excision. A radiation
therapy completed the treatment. Follow-up time was 19 months without
evidence of recurrence. Adenoid cystic carcinoma of the external
auditory canal is a rare tumor. It's a special type of carcinoma
developing from the ceruminous glands. Histogenesis is difficult and
unsettled. The most important survival factor is removal of the tumor
with histologically free margins. CONCLUSIONS: Lack of specific
clinical and radiological signs makes the diagnostic challenging. The
adenoid cystic carcinoma is a rare neoplasm of the external auditory
canal. An initial aggressive wide "en bloc" surgical resection is
mandatory.
Six cases of adenoid
cystic carcinoma in external auditory canal.Lin
Chuang Er Bi Yan Hou Ke Za Zhi. 2006 Feb;20(4):158-9.
OBJECTIVE: By
investigating the clinical and pathological features of adenoid cystic
carcinoma in external auditory canal, we can improve our ability of
diagnosis and treatment. METHOD: A retrospective analysis was
performed on 6 patients with adenoid cystic carcinoma in external
auditory canal, including clinical manifestations, the therapy as well
as the follow-up results. All cases underwent subtotal temporal bone
resection or other aggressive surgical encision. RESULT: All cases
were alive for a period from 8 to 21 months after subtotal temporal
bone resection or other aggressive surgical excision, without any
signs of regional lymph node metastasis and distal metastasis.
CONCLUSION: Adenoid cystic carcinoma in external auditory canal grows
slowly, so patients can live with the tumor for a long time. But the
long-term prognosis is poor. It is necessary to manipulate aggressive
surgical excision at the first time to improve cure rate.
Adenoid cystic
carcinoma of ceruminous gland: a case report.Indian
J Pathol Microbiol. 2006 Oct;49(4):587-9.
Adenoid cystic
carcinoma of the external auditory canal (EAC) is a very rare
malignant tumor and its diagnosis is frequently missed because of the
superficial nature of biopsies. A 30 year old male presented with 6
months history of recurrent painful right ear discharge. On
examination there was a nodule of 2 cms in diameter. The microscopic
examination of the punch biopsy specimen of tumor revealed typical
features of an adenoid cystic carcinoma. While reporting the biopsies
of external auditory canal one should keep the adenoid cystic
carcinoma as one of the possible differentials, especially if the
biopsy is superficial, problem is recurrent and histopathological
features suggest the granulation tissue.
Adenoid cystic
carcinoma of external auditory canal: a report of 7 cases.Lin
Chuang Er Bi Yan Hou Ke Za Zhi. 2004 Apr;18(4):202-3.
OBJECTIVE: To
detect the clinical and pathological features of the adenoid cystic
carcinoma of external auditory canal, and to improve its diagnosis and
treatment level. METHOD: A retrospective analysis was performed on 7
patients with ACCEAC by their clinical manifestation, the therapy and
follow-up results as well as the combination with the review of
related literature. RESULT: The period from the appearance of primary
symptoms to definite diagnosis averaged 5.7 years. All patients were
treated by surgical excision and followed up from 2 years 8 months to
9 years 11 months. Five of them were recurrent after operation, 2 of
which died. CONCLUSION: Adenoid cystic carcinoma of external auditory
canal, which is rarely seen in clinic, is not easy to exact diagnosis
in early stage. It progresses slowly and tends to invade parotid and
even intracranial cavity. It also has the tendency of recurrence and
pulmonary metastasis. So, its necessary to do both aggressive surgery
and postoperative irradiation. The long term follow-up indicates that
the tumor has a poor prognosis.
A
case of highly aggressive adenoid cystic carcinoma of the external
auditory canal.Acta
Otorhinolaryngol Ital. 2004 Dec;24(6):354-6.
Tumours of the
external auditory canal are extremely rare and only 20% of these are
of glandular origin. The most frequent histotype is adenoid cystic
carcinoma. The rarity of external auditory canal glandular tumours
explains the lack of large series reported in the literature and the
corresponding large number of case reports from different Authors.
Adenoid cystic carcinoma, presenting in the external auditory canal,
exhibits the same characteristics as those affecting the major
salivary glands, this tumour has an aggressive behaviour characterized
by local invasivity and with a metastatic risk of approximately 30%. A
rare case of adenoid cystic carcinoma of the external ear is reported.
The patient, a 75-year-old male, had right intermittent otorrhea for 6
years. On examination, a vegetating, ulcerated formation which easily
bled was found protruding from the right external auditory meatus.
Clinical, radiological and pathological features of the tumour are
described. A subtotal petrosectomy combined with homolateral elective
lymph node neck dissection was performed. Parotid gland, condyle of
the mandible and VII cranial nerve were spared since these were free
from disease.
Ceruminous gland adenoid cystic carcinoma with contralateral
metastasis to the brain.
Arch Pathol Lab Med. 2002
Jan;126(1):87-9.
We present the
case of a 38-year-old man with an adenoid cystic carcinoma originating
from the ceruminous glands of the external ear canal. The patient
subsequently presented with a contralateral brain mass that was also
diagnosed as adenoid cystic carcinoma. To our knowledge, contralateral
metastasis to the brain of a patient with an adenoid cystic carcinoma
of the ceruminous glands has not been reported previously. This rare
neoplasm should be considered in the differential diagnosis of poorly
differentiated carcinomas metastatic to the central nervous system in
patients with occult malignant neoplasms.
An
immunohistochemical study of adenoid cystic carcinoma of the external
auditory canal.Eur
Arch Otorhinolaryngol. 1993;250(4):240-4.
Specimens from
five cases of adenoid cystic carcinoma of the external auditory canal
were studied by immunohistochemical staining, and findings were
compared with those from adjacent non-neoplastic tissues containing
ceruminous glands. In the ceruminous gland, cytokeratin showed diffuse
positive staining, while myoepithelial cells were stained for smooth
muscle actin, desmin, S-100 protein and vimentin. The epithelial
markers used were cytokeratin, carcinoembryonic antigen and secretory
component and stained at various densities the inner cells of the
tubular component and duct-lining cells in the cribriform component of
tumor tissues. In contrast, the muscular markers, smooth muscle actin
and desmin, and the mesenchymal marker, vimentin, were positive in the
outer cells of the tubular component and in the cyst-lining cells of
the cribriform component. S-100 protein immunoreactivity showed
paradoxical results; positive findings occurred in the myoepithelial
cells of the ceruminous glands and in the inner cells of the tubular
component and duct-lining cells of the cribriform component of the
tumor. Present findings demonstrate that adenoid cystic carcinoma of
the external auditory canal had dual epithelial and myoepithelial
differentiation and can mimic the ceruminous glands of the auditory
canal.
Adenoid cystic
carcinoma involving the external auditory canal: a clinicopathologic
study of 16 cases. Cancer 1982;50:2873–2883.
Sixteen
patients with a rare tumor, adenoid cystic carcinoma (ACC) involving
the external auditory canal, have been studied. Clinically, most
patients complained of ear pain, often of several years duration. On
physical examination, a mass or a nodule usually was identified in the
ear canal. In most cases, treatment consisted of a wide surgical
resection of the auditory canal and adjacent structures.
Histologically, these neoplasms had the same appearance as ACC
originating in salivary glands. In eight cases, the tumor was confined
to the ear canal wall and unquestionably arose in this area, probably
within the ceruminous glands. When incompletely excised, these lesions
usually recurred locally. Nine patients had a total of 26 local
recurrences. Most recurrences were found within two years of the
preceding treatment, but the interval in some cases was long, ranging
up to 14 years. Of the 16 patients, seven had no evidence of
recurrence following surgical resection, two were living with
recurrent, unresectable tumor, five had died of disease, one had died
of other causes, and one was lost to follow-up. Some patients died of
tumor after a prolonged clinical course with multiple recurrences.
Death usually was caused by intracranial extension by the tumor, or by
pulmonary metastases. Radiotherapy did not appear to cure the lesion,
but probably resulted in palliation. An increased incidence of
recurrent, unresectable tumor or of death from the neoplasm correlated
with the following histologic features: demonstration of tumor on the
lines of surgical excision, involvement of the parotid gland,
extension into bone, perineural invasion and local recurrence of
tumor.
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