ABSTRACT
Objective To summarize the clinical characteristics and prognosis of lacrimal gland adenoid cystic carcinoma with high-grade transformation (LACC-HGT).Methods A retrospective study was adopted.Seventeen patients with lacrimal gland adenoid cystic carcinoma (LACC) were collected from August 2008 to March 2017 in Tianjin Medical University Eye Hospital.Hematoxylin-eosin staining and immunohistochemical staining were performed on tumor sections of 17 LACC patients.According to the pathology results,the patients were divided into LACC-HGT group (6 patients) and non-LACC-HGT (NLACC-HGT)group (11 patients),and the clinical characteristics and prognosis of the two groups were analyzed by using Fisher's exact test and Log-Rank test.Results The medical histories,clinical features,imaging features,TNM staging and treatment protocols were not significantly different between the two groups (all at P＞ 0.05).The 2-year local recurrence rate,5-year distant metastasis rate and 5-year death rate of patients with LACC-HGT were significantly higher than patients with NLACC-HGT (all at P＜0.05).Survival analysis results showed that the survival time of LACC-HGT group was obviously shorter than that of NLACC-HGT group.Conclusions LACC-HGT accelerate the invasion process of local recurrence and distant metastasis,and enhance the death rate.The detection of HGT components should be considered in the process of LACC diagnosis.
ABSTRACT
This was a case of a young lady presenting with 10 year history of a mass in the right eye. It was found to be an adenocarcinoma of the lacrimal gland from histopathological biopsy. She underwent wide excision, orbital exenteration and reconstruction with a free rectus abdominis flap. Unfortunately, she had a tumour recurrence which was not controlled by radiotherapy and a second excision. The behavior of the tumour was aggressive, resulting in widespread metastases. She passed away within a year of her presentation. Of note, the histopathology report from the second excision turned out to be sarcomatoid carcinoma. This is described in the literature as dedifferentiation, or high grade transformation (HGT). Occurrence of dedifferentiation in salivary gland tumours is well-established, but not as well-described in lacrimal gland tumours. In this case, there was a severely delayed presentation of a lacrimal gland adenocarcinoma in a young person, which underwent dedifferentiation into a sarcomatoid carcinoma. This phenomena is associated with aggressive tumour biology behavior and poor prognosis, despite surgery and radiotherapy.
Subject(s)
Adenocarcinoma , Lacrimal ApparatusABSTRACT
The Mucosa-associated lymphoid tissue (MALT) lymphoma, which was first described in 1983, is known to be caused by chronic Helicobacter pylori (HP) infection, which triggers lymphoid infiltration and formation of organized lymphoid tissue. In approximately two thirds of cases of MALT, the lymphoma has been observed to regress after treatment of H. pylori infection; this provides strong evidence of a causative role of HP in the etiology of MALT. We report a case of a 67-year-old female patient with a high-grade MALT lymphoma of the liver; this occurred six years after complete remission of a low-grade gastric MALT lymphoma and after complete eradication of H. pylori. there was no recurrence of the previous low-grade gastric MALT lymphoma. Based on radiological and pathologic findings, the high-grade MALT was considered to result from transformation of the low-grade gastric MALT lymphoma.