CARCINOMA ADENOIDE QUISTICO PDF
O carcinoma adenóide quístico é uma neoplasia epitelial maligna de origem glandular, ocorrendo nas glândulas mamárias, salivares e raramente no pulmão, . El carcinoma adenoide qusítico ha sido considerado hasta hace poco tiempo un tumor “frontera” entre los benignos y malignos por su bajo grado de malignidad. Objetivo. Revisar los hallazgos radiológicos del carcinoma adenoide quístico ( CAQ), así como su presentación clínica. Material y método. Realizamos un.
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Sinonasal Adenoid Cystic Quiatico Clinical Case Report and Literature Review. Maxilofacial-Head and Neck Radiologist. We present the case of a patient, a 59 year-old man, with Sinonasal Adenoid Cystic Carcinoma. Magnetic resonance exam revealed invasion of the right orbit and brain at the level of the anterior cranial fossa floor.
Due to the large volume, we decided to perform radio-chemotherapy treatment to diminish the size of the lesion. On conclusion of the first stage of treatment, reduction in tumor size was confirmed by computerized tomography exam and we decided to perform surgical resection with right ocular globe preservation. At present the patient is under periodic control and without major complications. Adenolde present the clinical case of a patient, a year-old man, diagnosed by means of biopsy as having Sinonasal Adenoid Cystic Carcinoma with intracranial extension and brain involvement.
In T1 sequence of the magnetic resonance MR we observed an isointense mass in the ethmoid sinus, infiltrating into the extraconal fat of the right orbit, with lateral displacement of the medial straight muscle associated with ipsilateral exophthalmia Fig.
In T2 sequence, we observed that the mass was shown to be predominantly hyperintense with involvement of brain tissue at the level of the anterior cranial fossa floor Fig. We also observed involvement of the ethmoid, right orbit, nasal fossae and infiltration into the anterior cranial fossa floor Figs.
After the case was evaluated by the Head and Neck Oncology Committee, it was decided to perform initial therapeutic management with concomitant radiotherapy and chemotherapy, due to the extension of the tumor, which prevented initial surgical management.
After the first stage of treatment, we verified a partial response of the tumor. Computerized Tomography CT showed a reduction in tumor volume, which maintened its infiltrative characteristics in relation to the lamina papyracea on the right side Fig.
In the CT after the injection of endovenous contrat, we observed heterogeneous reinforcement Figs. MR T1 – isointense mass in the ethmoid sinus with involvement of right extraconal fat. MR T2 – hyperintense areas at the level of the brain perenchyma.
MR T1 with contrast – marked heterogeneous reinforcement.
Carcinoma adenoide quístico de mama | Radiología
MR T1with contrast – infiltration into the anterior cranial fossa floor. CT, axial view, with a bone window, showing infiltration of the nasal bones and the papyracea lamina on the right side.
CT, Axial view, with a soft tissue daenoide, revealing a reduction in tumor size in the quiistico direction. CT post-contrast, coronal view, with a soft tissue window, showing a heterogeneous mass that occupies the superior half of the nasal fossa. HE Staining, epithelial cell niches with hyperchromatic nuclei.
After a second evaluation by the Oncology Committee, it was decided to perform surgery with a transethmoid approach, with ocular globe preservation.
The post-surgical biopsy confirmed the diagnosis of ACC Fig.
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At present the patient is under periodic observation, for eventual control of recurrence. As the surgical procedure resulted in a large cavity in the nasal region, separated from the cranial cavity by only thin layer of soft tissue, there is a high risk of manifestation of a cephalorachidian liquid fistula, which is also under control.
It was described for the first time by Robin, Lorain and Laboulbene, in two articles published in and Bradley, Adenoude denomination Adenoid Cystic Carcinoma used at present was introduced by Reid, in ACC is ranked the second non-epidermoid epithelial malignant tumor, after adenocarcinoma, frequently appears between the ages of 40 and 60 years, and affects men and women equally Riera et al. Three histological types are recognized: ACC with a tubular pattern is the type that presents the best prognosis; the more quistick Lupinetti et al.
The sinonasal ACC frequently develops slowly and asymptomatically, and presents nonspecific inflammatory characteristics, which leads to late diagnosis Sequeiros Santiago et al. Many patients present extension of the tumor into vital structures, such as the duramater, brain, orbit, carotid artery and cranial nerves.
Carcinoma adenoide quístico | Actas Dermo-Sifiliográficas (English Edition)
Distant metastases may be found in the lungs most frequentlybones, liver and brain, in many cases occurring decades after treatment. Metastasis to the lymph nodes is very uncommon Kumar et al.
Distant metastasis appears to be an important factor in determining the survival rate. There are reports showing that patients with ACC close to the base of the skull present a significantly qistico risk of local recurrence, in view of the difficulty of achieving adequate safety margins, due to the difficulty of the surgery, extension of the tumor into the intracranial nerves and restriction of the limits of resection imposed by the proximity of neural and vascular structures Kumar et al.
The treatment of choice for ACC that compromises the base qistico the skull is radical surgery combined with radiotherapy Lupinetti et al. The scope of the surgery must be quiistico wide as possible and demands broad and modulable surgical access, according to the extension of the tumor. Post operative radiotherapy increases local control, and therefore, survival Riera et al. CT and MR, with and without endovenous contrast are commonly used to determine the margins, extension and tumor infiltration pattern, as well as to determine perineural invasion at the base of quisitco skull.
Metastasis and extension into various structures are generally evaluated by means of radiographs, echotomography and scintillography Lupinetti et al. Thus, imaging exams are doubtlessly one of the key therapeutic and post treatment carcimoma strategies. Adenocarcinoma of ethmoid sinus: Adenoid cystic carcinoma of the head and neck: Patterns and incidence of neural invasion in patients with cancers of the paranasal sinuses. Adenocarcinoma de mucosa etmoidal.
Carcinoma adenoide quístico
Adenoid cystic carcinoma of the skull base. Adenoid cystic carcinoma ademoide nasal cavity – a case report. Sinonasal adenoid cystic carcinoma: Anderson Cancer Center experience. Morphology and the natural history of cribriform adenocarcinoma adenoid cystic carcinoma. Adenoid cystic carcinoma of the maxillary sinus. Radiotherapy after surgery for advanced adenoid cystic carcinoma of paranasal sinus. Adenoid cystic carcinoma of the sinonasal tract: