Guo Yang, Huang Qiang, Du Huaidong
ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, People's Republic of China.
Sci Prog. 2024 Oct-Dec;107(4):368504241308735. doi: 10.1177/00368504241308735.
In head and neck, adenoid cystic carcinoma (ACC) is a rare malignant tumor. ACC mainly generated from minor salivary glands, especially in the palate. We report an extremely rare case of ACC generating in the left palatine tonsil. A 50-year-old woman with foreign body sensation in the pharynx for 6-month was admitted to our hospital. Physical examination revealed a dark red mass in the soft palate near the upper pole of the left tonsil. Preoperative imaging examinations indicated a low-density mass in the left tonsillar area on the CT plain scan, which was a hyperintense mass at the anterior superior pole of the left tonsil on T2-weighted MRI. Complete surgical resection of the mass together with the left palatine tonsil was conducted under general anesthesia. The diagnosis of ACC was established based on histopathology and immunohistochemistry results. Then, postoperative radiotherapy of 60 Gy was administered. During regular medical follow-up for 12 months, no local recurrence was observed. Complete surgical resection, with or without postoperative radiotherapy is generally acknowledged as the standard of care for ACC. Despite the extremely low incidence in palatine tonsil, clinicians should consider the differential diagnosis of ACC.
在头颈部,腺样囊性癌(ACC)是一种罕见的恶性肿瘤。ACC主要起源于小唾液腺,尤其是腭部。我们报告一例极其罕见的发生于左侧腭扁桃体的ACC病例。一名50岁女性因咽部异物感6个月入院。体格检查发现左侧扁桃体上极附近软腭有暗红色肿物。术前影像学检查显示CT平扫左侧扁桃体区有低密度肿物,T2加权磁共振成像(MRI)显示左侧扁桃体前上极有高信号肿物。在全身麻醉下完整切除肿物及左侧腭扁桃体。根据组织病理学和免疫组化结果确诊为ACC。随后给予60 Gy的术后放疗。在12个月的定期医学随访期间,未观察到局部复发。完整手术切除,无论是否进行术后放疗,通常被认为是ACC的标准治疗方法。尽管腭扁桃体的发病率极低,但临床医生应考虑ACC的鉴别诊断。