Analysis of the efficacy of endoscopic transnasal surgery for sinonasal and skull base adenoid cystic carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the efficacy of endoscopic transnasal surgery for sinonasal and skull base adenoid cystic carcinoma (ACC), and to analyze the prognostic factors. Methods: Data of 82 patients (43 females and 39 males, at a median age of 49 years old) with sinonasal and skull base ACC who were admitted to XuanWu Hospital, Capital Medical University between June 2007 and June 2021 were analyzed retrospectively. The patients were staged according to American Joint Committee on Cancer (AJCC) 8th edition. The disease overall survival(OS) and disease-free survival(DFS) rates were calculated by Kaplan-Meier analysis. Cox regression model was used for multivariate prognostic analysis. Results: There were 4 patients with stage Ⅱ, 14 patients with stage Ⅲ, and 64 patients with stage Ⅳ. The treatment strategies included purely endoscopic surgery (n=42), endoscopic surgery plus radiotherapy (n=32) and endoscopic surgery plus radiochemotherapy (n=8). Followed up for 8 to 177 months, the 5-year OS and DFS rates was 63.0% and 51.6%, respectively. The 10-year OS and DFS rates was 51.2% and 31.8%, respectively. The multivariate Cox regression analysis showed that late T stage and internal carotid artery (ICA) involvement were the independent prognostic factors for survival in sinonasal and skull base ACC (all P<0.05). The OS of patients who received surgery or surgery plus radiotherapy was significantly higher than that of patients who received surgery plus radiochemotherapy (all P<0.05). Conclusions: Endoscopic transonasal surgery or combing with radiotherapy is an effective procedure for the treatment of sinonasal and skull base ACC. Late T stage and ICA involvement indicate poor prognosis.

Incidental Discovery of Acinic Cell Carcinoma of the Oral Mucosa with Metachronous Adenoid Cystic Carcinoma of the Upper Lip / Hallazgo Incidental de Carcinoma de Células Acinares de la Mucosa Oral con Carcinoma Adenoide Quístico Metacrónico del Labio Superior

ABSTRACT: Multiple salivary gland tumors represent an unusual event characterized by the development of composite lesions originated from minor or major salivary glands. These neoplasms can be categorized into three perspectives: Histologic type, time of appearance and topographic distribution. We report an unusual case of a 73-year-old black man with an acinic cell carcinoma (ACC) of the oral mucosa discovered incidentally during surgical removal of an adjacent mucocele. Approximately one year after the first consultation, the patient was seen at the local cancer reference center with a third lesion that was diagnosed as an adenoid cystic carcinoma (AdCC) of the upper lip. The patient underwent surgical reconstruction of the treated areas and has been free of the disease for the past year. To our knowledge, the combination of ACC and AdCC in intraoral sites has not been reported in the literature.

RESUMEN: Los tumores de glándulas salivales múltiples representan un evento inusual caracterizado por el desarrollo de lesiones compuestas, originadas en glándulas salivales menores o mayores. Estos neoplasmas se pueden categorizar en tres perspectivas: tipo histológico, tiempo de aparición y distribución topográfica. Reportamos un caso inusual de un hombre negro de 73 años con un carcinoma de célula acínica (ACC) de la mucosa oral descubierta incidentalmente durante la extirpación quirúrgica de un mucocele adyacente. Aproximadamente un año después de la primera consulta, el paciente se presentó en el centro de referencia del cáncer local con una tercera lesión que fue diagnosticada como carcinoma adenoide quístico (AdCC) del labio superior. El paciente se sometió a la reconstrucción quirúrgica de las áreas tratadas y durante el último año no ha presentado recurrencia de la enfermedad. De acuerdo a nuestro conocimiento la combinación de ACC y AdCC en sitios intraorales no se ha informado en la literatura.

Carcinoma adenoide quístico de cavidad nasal y senos paranasales: experiencia de 5 años en Clínica Las Condes de Santiago de Chile / Adenoid cystic carcinoma of nasal cavity and paranasal sinuses: 5 years experience in las Condes Clinic of Santiago of Chile

RESUMEN Introducción: El carcinoma adenoide quístico es una neoplasia originada en glándulas exocrinas de todo el cuerpo, principalmente en glándulas salivales mayores. En cavidad nasal y senos paranasales es poco frecuente y se caracteriza por presentar una alta frecuencia de recurrencia y de metástasis a distancia posterior a su remisión y a pesar de su tratamiento. Objetivo: Describir características de una serie de casos de pacientes con carcinoma adenoide quístico de cavidad nasal y senos paranasales operados. Material y método: Estudio descriptivo-retrospectivo. Período enero de 2012 y enero de 2017. La información se obtuvo a partir de las fichas electrónicas de la Clínica Las Condes. Se describen procedencia, edad y sexo, características clínicas, hallazgos anatomopatológicos, métodos diagnósticos, tratamiento, evolución. Resultados: Total de 5 pacientes operados, 3 mujeres y 2 hombres. La edad promedio fue de 63 años, con rango de 33 años a 90 años de edad. 100% de los casos sin factores asociados. La presentación clínica más frecuente fue la obstrucción nasal unilateral, seguida por el dolor facial. Dos pacientes se presentaron con diagnóstico inicial, dos por recurrencia y uno por persistencia. En tres casos el tumor se origina de seno maxilar y en dos en seno etmoidal. Todos presentaron enfermedad avanzada, etapa IV y III. Tres pacientes histológicamente fueron de bajo grado y dos de alto grado. En los cinco casos el tratamiento primario fue quirúrgico, en el 60% endoscópico, 20% abierto y 20% combinado. En cuatro casos se usó radioterapia posoperatoria y en tres de éstos, quimioterapia concomitante. Todos se encuentran sin signos de recidiva tumoral en último control. Conclusiones: El carcinoma adenoide quístico de cavidad nasal y senos paranasales es bastante infrecuente, su incidencia es menor a 1/100.000 casos por año. Es más frecuente en mujeres entre 40 y 50 años. Se identifica más con su origen en el seno maxilar (50%) y de patrón cribiforme. Clínicamente se presenta en estadíos avanzados ya que en etapa precoz es asintomático o presenta clínica inespecífica inflamatoria. El diagnóstico se realiza con biopsia complementada con imagenología. El tratamiento más utilizado es la cirugía endoscópica o abierta asociado a radioterapia posoperatoria, a pesar de la cual, se presentan con alta recurrencia a largo plazo.

ABSTRACT Introduction: Adenoid Cystic Carcinoma is a neoplasm originating in exocrine glands throughout the body, mainly in the major salivary glands. In the nasal cavity and paranasal sinuses is rare and characterized by a high frequency of recurrence and distant metastasis after remission and despite its treatment. Aim: To describe characteristics of a series of patients with operated adenoid cystic carcinoma of the nasal cavity and paranasal sinuses. Material and method: Descriptive-retrospective study. Period January 2012 and January 2017. The information was obtained from the electronic tabs of the Las Condes Clinic. It describes origin, age and sex, clinical characteristics, anatomopathological findings, diagnostic methods, treatment, evolution. Results: Total 5 patients operated, 3 women and 2 men. The average age was 63 years, ranging from 33 years to 90 years of age. 100% of the cases without associated factors. The most frequent clinical presentation was unilateral nasal obstruction, followed by facial pain. 2 patients presented with initial diagnosis, 2 due to recurrence and 1 due to persistence. In 3 cases the tumor originates from the maxillary sinus and in 2 in the ethmoidal sinus. All had advanced disease, stage IV and III. 3 patients were histologically low grade and 2 high grade. In all 5 cases, the primary treatment was surgical, 60% endoscopic, 20% open and 20% combined. In 4 cases, postoperative radiotherapy was used and in 3 of this concomitant chemotherapy. All are without signs of tumor recurrence in the last control. Conclusion: Adenoid Cystic Carcinoma of the nasal cavity and paranasal sinuses is quite infrequent; its incidence is less than 1/100,000 cases per year. It is more common in women between 40 and 50 years. It is identified more with its origin in the maxillary sinus (50%) and cribriform pattern. Clinically it presents in advanced stages since at an early stage, it is asymptomatic or it presents nonspecific inflammatory clinic. Diagnosis is performed with biopsy supplemented with imaging. The most commonly used treatment is endoscopic or open surgery associated with postoperative radiotherapy, despite which, they present with high recurrence in the long term.

Múltiplos cilindromas dérmicos, tratamento adequado e revisão da literatura / Multiple dermal cylindroma, appropriate treatment and literature review

Os cilindromas são tumores de apêndices cutâneos. Apresentamse normalmente na área da cabeça e pescoço. Muitas modalidades foram descritas para seu tratamento. Apresentamos aqui o caso de uma idosa que se apresentou com lesões recorrentes e que recebeu a opção de fazer uma excisão radical de todas as lesões versus a excisão das lesões sintomáticas. Ela optou por remover as lesões sintomáticas. A excisão cirúrgica das lesões sintomáticas é uma alternativa razoável para pacientes idosos.

Cylindromas are tumors of skin appendages. They present most commonly in the head and neck area. Many modalities have been described to treat them. We present a case of an elderly female who presented to us with recurrent lesions and was offered radical excision of all lesions versus excision of symptomatic lesions. She opted for the removal of symptomatic lesions. Surgical excision of symptomatic lesions is a reasonable alternative in elderly patients.

Carcinoma adenoideo quístico de mama: serie de casos / Adenoid cystic carcinoma of the breast: case series

El carcinoma adenoideo quístico (CAQ) de mama es un cáncer poco frecuente y representa entre el 0,1% y el 0,4% de todos los carcinomas de mama. A continuación se presentan dos casos con el objetivo de describir un tipo de carcinoma de mama de presentación poco frecuente con evolución clínica no común. El primero de una mujer de 34 años y el segundo de una mujer de 44 años, ambas con diagnóstico confirmado de CAQ de mama. El CAQ de mama es de predominio en el sexo femenino en la etapa postmenopáusica. Sin embargo, ambas pacientes presentaron el CAQ en edad fértil. Generalmente posee un pronóstico favorable con rara diseminación, a diferencia de estos dos casos presentados donde se observa varias metástasis a distancia y un curso muy agresivo de la enfermedad.

Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm and accounts for 0.1% to 0.4% of all breast carcinomas. This is a description of two clinical cases that describe a rare presentation with an uncommon clinical course. The patients are 34 and 44 year old women, both with a confirmed diagnosis of ACC of the breast. The ACC of the breast predominantly grows in postmenopausal women. However, both patients are still fertile. Commonly it has a favorable prognosis and a rare presentation of metastasis. Nevertheless, in both cases, distant dissemination and an aggressive course of the disease was observed.

Primary cutaneous adenoid cystic carcinoma of the eyelid and literature review / Carcinoma adenóide cístico cutâneo primário de pálpebra e revisão da literatura

ABSTRACTPrimary cutaneous adenoid cystic carcinoma (PCACC) is a rare malignant epithelial tumor most commonly observed in the scalp and skin of the chest and originating from the palpebral portion of the lacrimal gland in the orbit. Here we describe the diagnosis and treatment of a rare case of PCACC in an eye of a 52-year-old male. The patient presented with a mass lesion of the right lower eyelid. During incisional biopsy, lack of encapsulation and a secretion pattern different to that of chalazion was observed, which differentiated the lesion from chalazion. Pathological analysis revealed the diagnosis of PCACC. This case highlights the importance of careful inspection for macroscopic differentiation of PCACC from chalazion after initial surgery and pathological evaluation of all surgically removed mass lesions for accurate diagnosis and treatment.

RESUMOO carcinoma adenóide cístico cutâneo primário (PCACC) é um tumor maligno epitelial raro, mais comumente observado no couro cabeludo e na pele do peito sendo originário da porção palpebral da glândula lacrimal na órbita. Apresentamos o diagnóstico e tratamento de um caso raro de carcinoma adenóide cístico cutâneo primário do olho em um paciente do sexo masculino de 52 anos de idade, com uma lesão maciça da pálpebra inferior direita. A observação da falta de encapsulamento e um padrão de secreção diferente do calázio durante biópsia incisional permitiu a diferenciação da lesão de um calázio. A avaliação dos resultados do exame patológico resultou no diagnóstico de carcinoma adenóide cístico cutâneo primário. A análise do caso indica a importância de uma inspeção cuidadosa para a diferenciação macroscópica da carcinoma adenóide cístico cutâneo primário do calázio após a cirurgia inicial e avaliação patológica de todas as lesões de massa removidas cirurgicamente para o diagnóstico e tratamento corretos.

Study of Salivary Gland Neoplasms.

Tumors of the salivary glands are uncommon and they present a great variety of histological types with many structural variation. They have a low incidence and their anatomical relationship especially that of the parotid gland to the facial nerve make their management challenging. The present study was carried out to find out the prevalence of salivary gland neoplasms, to see associated conditions like sialadenitis, sialolithiasis coexisting with salivary gland neoplasms and to do cytohistopathological correlation. Total 96 cases were collected of which 66.7% were benign and 33.3% were malignant. In 81 (84.3%) cases tumors occurred in major salivary gland while 15 (15.6%) cases in minor salivary gland. Among major salivary gland, parotid was the commonest site and in minor salivary glands, palate was the commonest site followed by lips. Pleomorphic adenoma was the commonest benign tumor and adenoid cystic carcinoma was the commonest malignant tumor followed by mucoepidermoid tumor. There was one case of synovial sarcoma. Associated pathology like sialadenitis and sialolithiasis were present in 16 benign and 5 malignant tumors. Cytohistocorrelation was seen in 63 out of 64 (98.4%) benign and 16 out of 18 (88.8%) malignant tumors.

Carcinoma papilar pancreático sólido y quístico / Solid and cystic pancreatic papillary carcinoma

Paciente femenina de 22 años. Quince días antes del ingreso comenzó con dolor en el hemiabdomen superior que se intensificaba con la ingestión de alimentos, acompañado de sensación de plenitud. Se encontraron niveles de amilasa sérica dentro de límites normales. Los estudios imagenológicos, tanto la ecografía como tomografía axial computarizada, revelaron una masa tumoral en la cola del páncreas de contornos bien definidos y vascularizados. Se intervino quirúrgicamente y se realizó la exéresis total de la lesión. El estudio anátomo-patológico confirmó que se trataba de un carcinoma papilar pancreático sólido y quístico. Posteriormente, la paciente recibió tratamiento con quimioterapia y radioterapia. Los exámenes imagenológicos evolutivos no mostraron recidivas locales, ni metástasis a distancia. La paciente ha tenido buena respuesta al tratamiento y hoy conserva buen estado de salud.

A 22 years-old female patient who began feeling some pain in the upper hemiabdomen that became intensive after food consumption and the feeling of having eaten too much. The serum amylase levels were within the normal limits. The imaging studies both echography and computerized axial tomography disclosed a well-defined and vascularized tumor mass in the tail of pancreas. She was operated on to completely remove the lesion. The anatomopathological study confirmed the diagnosis of solid and cystic pancreatic papillary carcinoma. Later on, the patient received chemotherapy and radiotherapy. The evolutional imaging tests did not show either local relapses or distant metastasis. The patient responded well to treatment and her health status is good nowadays.

Management of a case of left tracheal sleeve pneumonectomy under cardiopulmonary bypass: Anesthesia perspectives.

The lung tumors with carinal involvement are frequently managed with tracheal sleeve pneumonectomy and tracheobronchial anastomosis without use of cardiopulmonary bypass (CPB). Various modes of ventilation have been described during tracheal resection and anastomosis. Use of CPB during this period allows the procedure to be conducted in a more controlled way. We performed tracheal sleeve pneumonectomy for adenoid cystic carcinoma of left lung involving carina. The surgery was performed in two stages. In the first stage, left pneumonectomy was performed and in the second stage after 48 h, tracheobronchial resection and anastomosis was performed under CPB. Second stage was delayed to avoid excessive bleeding (due to heparinization) from the extensive vascular raw area left after pneumonectomy. Meticulous peri‑operative planning and optimal post‑operative care helped in successful management of a complex case, which is associated with high morbidity and mortality.

Carcinoma adenoideo quístico / Adenoid cystic carcinoma

El carcinoma adenoide quístico representa aproximadamente un 25 por ciento de los tumores de cabeza y cuello, ubicado principalmente a nivel de paladar, labio y mucosa bucal. Mantiene un curso lento pero con probabilidad de metástasis a largo plazo con diseminación de predominio vascular y raramente a nódulos linfáticos. Clínicamente se manifiesta como indolente manifestado principalmente como una masa. El método diagnóstico más importante es el examen físico con exámenes complementarios por medio de ultrasonido y dependiendo de características propias de la masa se solicitar resonancia magnética para delimitar patología como guía durante procedimiento quirúrgico. Como tratamiento de primera línea se utiliza la resección quirúrgica y se ha demostrado mejores resultados con la agregación de radioterapia.

Tumor híbrido parotídeo / Parotid hybrid tumor

Los tumores de glándulas salivales representan el 3%-10% de las neoplasias de cabeza y cuello. La localización más común es en la glándula parótida, representando el 50%-85% de los casos, siendo 20%-30% de ellos malignos. Los siguientes son indicadores de malignidad: Crecimiento acelerado, masa dolorosa, parálisis facial asociada y linfoadenopatía. La mayoría de las neoplasias de parótida derivan de un único tipo histológico, pero eventualmente puede ocurrir el desarrollo de más de un tipo en la misma glándula. Este trabajo presenta un caso de una neoplasia en parótida con dos tipos histológicos diferentes, con una presentación clínica atípica. El paciente se presentó inicialmente con otalgia y otorrea, al examen destacaba un tumor en el canal auditorio externo. El estudio complementario evidenció una neoplasia de parótida y se realizó resección total de la glándula. La biopsia informó un carcinoma adenoideo-quístico con áreas basaloideas diferenciadas. Se administró radioquimioterapia adyuvante, y el control imagenológico con PET-TC mostró la ausencia de recurrencias o diseminación del tumor.

Tumors of the salivary glands represent 33%-10% of head and neck neoplasms. The most common location is the parotid gland, accounting for 50%-85% of the cases, with 20%-30% of them being malignant. The following are known to be indicative of a malignant tumor: fast growing, painless mass, associated facial paralysis and lymphadenopathy. Most parotid neoplasm derive from a single histological type but eventually the development of more than one type on the same gland can occur. This paper presents a case of a parotid neoplasm with two different histological tumors, with uncharacteristic clinical presentation. The patient presented initially with ear pain and otorrhoea, in the clinical examination highlighted an external auditory canal tumor. The complementary study revealed a parotid neoplasm and a total resection of the gland was performed. The biopsy revealed an adenoid-cystic carcinoma with differentiated basaloid areas. Adjuvant radio-chemotherapy was administered, and the imaging control with PET-CT showed no evidence of recurrence or dissemination of the tumor.

Sinonasal adenoid cystic carcinoma: clinical case report and literature Review / Carcinoma adenoide quístico nasosinusal: caso clínico y revisión de la literatura

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...

Se presenta el caso de un paciente de sexo masculino de 59 años con carcinoma adenoide quístico nasosinusal. El examen de resonancia magnética reveló la invasión de la órbita derecha y el cerebro a nivel del suelo de la fosa craneal anterior. Debido al gran volumen, se decidió realizar el tratamiento de radio-quimioterapia para disminuir el tamaño de la lesión. Al término de la primera etapa del tratamiento, la reducción del tamaño del tumor fue confirmada por el examen de tomografía computarizada y se decidió realizar una resección quirúrgica con preservación del globo ocular derecho. En la actualidad el paciente se encuentra bajo el control periódico y sin mayores complicaciones...

Carcinoma adenoide quístico primario de bronquio lobar: caso clínico / Primary adenoid cystic carcinoma of the lobar bronehus: case report

Primary airway adenoid cystic carcinoma is very uncommon. We report a 60 years old male consulting for hemoptysis and dyspnea. A chest CAT scan showed a mass in the right superior lobar bronehus. The patient was subjected to a right superior sleeve lobectomy and the pathological study of the surgical piece revealed an adenoid cystic carcinoma. The patient received adjuvant radiotherapy. Surgery and radiation therapy are the mainstay of treatment for this type of tumors.

El carcinoma adenoide quístico primario de la vía aérea es una neoplasia muy rara. Reportamos el caso de un paciente de 60 años de edad quien consultó por hemoptisis y disnea de esfuerzo. Una tomografía computarizada del tórax reveló una masa en el bronquio fuente y lobar superior del pulmón derecho. Se realizó una lobectomía superior derecha en manguito. El estudio histopatológico mostró un carcinoma adenoide quístico. Se administró radioterapia adyuvante. La cirugía y la radioterapia son las bases del manejo de este tipo de tumores.

Comparison of obturator design for acquired maxillary defect in completely edentulous patients.

The most challenging and appreciated area in the field of Prosthodontics is the rehabilitation of maxillary defects. Tumors of the head and neck are the common cause for acquired maxillofacial defects. Surgical consequences predispose the patient to hypernasal speech, fluid leakage into nasal cavity, impaired masticatory function, and cosmetic deformity. The Prosthodontists play a significant role in the intervention and improve the quality of life of such patients. The current article describes two clinical case reports of completely edentulous patients with acquired maxillary defects.

[ tracheal adenoid cystic carcinoma]

Adenoid cystic carcinoma [CACC], also called cylindroma, are rare epithelial malignant tumors, their favorite seat is at the salivary glands [95% of cases], they represent 20 to 40% of tracheal carcinoma and 0,1% of respiratory tract cancers. Bronchial localization is rare, estimated only between 0.3 and 2%. This is a retrospective study ranging from 1997 to 2006 concerning five patients treated in the thoracic surgery department, for tracheal tumor and whose final histological diagnosis was in favor of adenoid cystic carcinoma [ACC]. All the patients had inspiratory dyspnea. Bronchoscopy showed a smooth tracheal tumor, the biopsy revealed a ACC. Four of our patients underwent resection of the tumor-by-end anastomosis and one patient was deceased prior to surgery. Adjuvant radiotherapy was indicated in one case. The short term, outcome was good, but local recurrence with lung and cervical lymph node metastases appeared after 6 years in one patient. The adenoid cystic carcinoma of the trachea is a rare tumor. Its diagnosis and surveillanse based on bronchial Bibroscopy combined with biopsy. CT better evaluates the scope and extent of the peri tracheal tumor. The therapeutic management is based mainly on surgery combined with radiotherapy. adenoid cystic carcinoma of the trachea are rare malignant tumors issues to think about before a lesion at this level

Ten-year follow-up of a case series of primary epithelial neoplasms of the lacrimal gland: clinical features, surgical treatment and histopathological findings / Dez anos de acompanhamento de uma série de casos de neoplasias epiteliais primárias da glândula lacrimal: características clínicas, tratamento cirúrgico e achados histopatológicos

PURPOSE: To describe and analyze the features of a cases series of patients with primary epithelial neoplasms of the lacrimal gland, its surgical treatment, and histopathological findings. METHODS: Retrospective evaluation of files from patients with primary epithelial neoplasms of the lacrimal gland in the period from 1997 to 2007. All patients with primary epithelial tumors of the lacrimal gland were included in this study. Data on gender, age, clinical features, surgical treatment, histopathological findings and follow-up were collected. The slides with histological sections of the tumors were reviewed by the same pathologist. RESULTS: During the study period, there were 12 patients, 5 (41.7 percent) with benign tumors, all pleomorphic adenomas (benign mixed tumor) and 7 (58.3 percent) with malignant neoplasms, thus distributed: four cases of adenoid cystic carcinoma, two of mucoepidermoid carcinoma and one carcinoma expleomorphic adenoma. Globally, patients mean age was 54.1 years-old (ranging from 14 to 70 years-old), with mean age of 52.4 years-old (ranging from 14 to 65 years-old) for benign neoplasms, and 55.3years-old for malignant neoplasms (ranging from 26 to 70 years-old). Clinical follow-up information, ranging from 2 to 10 years-old, was available for all patients. Three patients developed distant metastasis and died of disease. CONCLUSIONS: The most frequent primary epithelial neoplasms of the lacrimal gland were pleomorphic adenoma and adenoid cystic carcinoma during the study period. Malignant tumors were more frequent than benign tumors. The histopathological diagnosis and the disease initial stage can play a significant role in patient's survival.

OBJETIVO: Descrever e analisar as características de uma série de casos de portadores de neoplasias epiteliais primárias da glândula lacrimal, o tratamento cirúrgico, assim como os achados histopatológicos. MÉTODOS: Avaliação retrospectiva dos arquivos de pacientes com neoplasias epiteliais primárias da glândula lacrimal, no período de 1997 até 2007. Todos os pacientes com tumores epiteliais primários da glândula lacrimal foram incluídos neste estudo. Foram analisados os dados sobre sexo, idade, características clínicas, tratamento cirúrgico, achados histopatológicos e seguimento dos pacientes. As lâminas com secções histológicas dos tumores foram revisadas pelo mesmo patologista. RESULTADOS: No período do estudo, foram encontrados 12 pacientes, sendo 5 (41,7 por cento) portadores de tumores benignos, todos adenomas pleomórficos (tumor benigno misto), e 7 (58,3 por cento) com neoplasias malignas, assim distribuídos: quatro casos de carcinoma adenóide cístico, dois de carcinoma mucoepidermóide e um de carcinoma ex-adenoma pleomórfico. Analisando-se de modo global, a idade média dos portadores foi de 54,1 anos (variando de 14 a 70 anos); com média de idade de 52,4 anos (variando de 14 a 65 anos) para neoplasias benignas, e 55,3 para neoplasias malignas (variando de 26 a 70 anos). Informações do seguimento, variando de 2 a 10 anos, estavam disponíveis para todos os pacientes. Três pacientes desenvolveram metástases distantes e morreram devido à doença. CONCLUSÕES: A maioria das neoplasias epiteliais primárias da glândula lacrimal foi o adenoma pleomórfico e o carcinoma adenóide cístico no período de estudo. Os tumores malignos foram mais frequentes que os benignos. O diagnóstico histopatológico e o estadiamento inicial da doença podem desempenhar uma papel significante na sobrevida do paciente.

Parotidectomía: experiencia en 3 años / Parotidectomy: experience in 3 years

Este trabajo descriptivo observacional expone la casuística de parotidectomías realizadas en el Hospital Universitario de Los Andes entre los años 2004 y 2007. De 23 pacientes con tumor de parótida 18 fueron mujeres. A todos se les practicó parotidectomías. El 64,3 por ciento eran mayores de 45 años, el aumento de volumen postoperatorio prevaleció en 22 pacientes. La PAAF fue benigna en 60,86 por ciento. La variedad histológica mas frecuente fue el Adenoma Pleoformórfico. La complicación mas frecuente fue lesión del nervio facial. El 80 por ciento de tumores de glándulas salivales afecta a la parótida. Aparecen en promedio a los 50 años de edad. La PAAF ofrece un diagnóstico preoperatorio cercano al definitivo, lo que evita una cirugía innecesaria. En este estudio existió concordancia del 100 por ciento entre PAAF e histopatología. La cirugía es el tratamiento indicado, preservando el nervio facial.

Carcinoma adenóide cístico de conduto auditivo externo / Adenoid cystic carcinoma of the external auditory canal

O carcinoma adenóide cístico é um raro tumor originado das glândulas salivares, principalmente quando se localiza no conduto auditivo externo. Apresenta alta taxa de invasão perineural e metástases, devendo ser tratado com combinação de cirurgia agressiva seguida de radioterapia. Relatamos um caso de carcinoma adenóide cístico de conduto auditivo externo em paciente de 77 anos com queixa de hipoacusia e otalgia. A mesma foi tratada com mastoidectomia radical e radioterapia.

Adenoid cystic carcinoma is a rare tumor originating from the salivary glands, especially when arise the external auditory canal. This tumor has high rate of perineural invasion and metastasis, then must be treated with aggressive surgery combined with postoperative radiation. We report a case of an adenoid cystic carcinoma arising the external auditory canal of 77 years old female patient, who complained hypoacusis and pain. She was treated by radical mastoidectomy and radiotherapy.