Neutron Radiotherapy for Adenoid Cystic Carcinoma of the Head and Neck

Buchholz, Thomas A.; Shimotakahara, S; Weymuller, Ernest A.; Laramore, George E.; Griffin, Thomas W.

doi:10.1001/archotol.1993.01880190043009

Cited by 54 publications

(24 citation statements)

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“…Some authors suggest exclusive radiation therapy of adenoid cystic carcinomas, which should be considered in particular for elderly or multimorbid patients. [24][25][26][27] Chemotherapy, on the other hand, is only administered for palliation. 1,13,17,28,29 The survival rates in the literature correspond to our data.…”

Section: Discussionmentioning

confidence: 99%

Adenoid Cystic Carcinoma of the Skull Base

Issing¹,

Hemmanouil²,

Stöver³

et al. 1999

Skull Base

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Section: Discussionmentioning

confidence: 99%

Adenoid Cystic Carcinoma of the Skull Base

Issing¹,

Hemmanouil²,

Stöver³

et al. 1999

Skull Base

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“…Early local recurrence and late distal metastasis are common in spite of radical extirpation of the primary tumor [4,8,9]. According to Shotton et al [10], cranial base invasion occurs along three routes: the eustachian tube, the mandibular and maxillary nerves, and the internal carotid artery.…”

Section: Discussionmentioning

confidence: 99%

Intrasellar Remote Metastasis from Adenoid Cystic Carcinoma of Parotid Gland: Case Report

et al. 2006

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Abstract. Adenoid cystic carcinoma is a tumor of exocrine glands originating primarily from the minor and major salivary glands, lacrimal gland, bronchus, breast, and intestinal and genital tracts. Intracranial remote metastasis from adenoid cystic carcinoma in salivary gland is quite rare. The authors encountered a case of intrasellar remote metastasis from an adenoid cystic carcinoma of parotid gland origin, presenting with hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). To our knowledge, this is the first reported case of metastasis from an adenoid cystic carcinoma to intrasellar area. A 78-year-old woman had an adenoid cystic carcinoma in the left parotid gland, which was resected surgically followed by local radiation therapy of 60 Gy. After 4 years, the patient presented with general malaise, followed by disturbed consciousness caused by hyponatremia. The clinical data showed severe hyponatremia induced by SIADH. An intrasellar heterogenous mass lesion compressing the optic chiasm was resected subtotally via an endonasal transsphenoidal approach. Histopathological examination of the tumor specimens revealed adenoid cystic carcinoma, which had identical histological findings as those of the painful superficial cervical lymph nodes resected in the same operation. Tumors such as the present case are easily confused with pituitary adenoma or craniopharyngioma. Although rare, metastasis from tumors including those of salivary gland origin should be considered in the differential diagnosis of unusual pituitary tumors. ADENOID cystic carcinoma is a tumor of exocrine glands originating primarily from the minor salivary glands of upper respiratory gland, the major salivary glands, lacrimal gland, bronchus, breast, and intestinal and genital tracts [1,2]. It is characteristically slow growing, but often invades the cranial base directly with rates of cranial base invasion between 4 and 22% [3]. However, intracranial remote metastasis from adenoid cystic carcinoma of the salivary gland is quite rare [4]. We encountered a case of intrasellar remote metastasis from an adenoid cystic carcinoma of parotid gland origin, presenting with hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). To our knowledge, this is the first reported case of remote metastasis from an adenoid cystic carcinoma in parotid gland to intrasellar area. Case ReportHistory A 78-year-old woman had an adenoid cystic carcinoma in the left parotid gland, which was resected surgically followed by local radiation therapy of 60 Gy. In the same year, the tumor recurred locally and tumor removal and segmental resection of the mandibular bone with reconstruction of mandible and middle pharynx were performed. Radiation therapy of 60 Gy was additionally delivered to the skull base. Since then, the patient had been stable without recurrence for 4 years. Then she presented with general malaise, followed by disturbance of consciousness with hyponatremia.

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“…Since experimental studies by Batterman et al in lung metastasis of adenoid cystic carcinomas revealed RBE (relative biological effectiveness) values as high as 8 after irradiation with fast neutrons [1], several prospective clinical trials have been carried out investigating fast neutron radiotherapy in adenoid cystic carcinomas [2,12,20,21,25]. In all studies there was observed a significantly higher local tumor control rate after high-LETRT compared to low-LET radiation therapy.…”

Section: Discussionmentioning

confidence: 99%